三种克氏针张力带治疗尺骨鹰嘴骨折的疗效比较  

Comparison of the efficacy of three types of Kirschner wire tension bands for ulnar olecranal fracture

作　　者：陈嘉如 牟哲飞 郑均炬 CHEN Jia-ru;MOU Zhe-fei;ZHENG Jun-ju(Department of Orthopaedic Surgery,Wenzhou Central Hospital,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州市中心医院骨科,浙江温州325000

出　　处：《中国骨伤》2023年第7期607-613,共7页China Journal of Orthopaedics and Traumatology

摘　　要：目的:比较3种常见的克氏针张力带治疗尺骨鹰嘴骨折的临床效果。方法:回顾分析2016年3月至2020年5月克氏针张力带固定治疗64例尺骨鹰嘴骨折患者的临床资料,克氏针髓内置钉组(A组)19例,男8例,女11例;年龄(48.2±18.3)岁,Mayo分型Ⅰ型3例,Ⅱ型16例。克氏针双皮质置钉组(B组)20例,男13例,女7例;年龄(43.5±20.4)岁,Mayo分型Ⅰ型3例,Ⅱ型17例。带孔克氏针组(C组)25例,男15例,女10例;年龄(55.2±17.5)岁,Mayo分型Ⅰ型4例,Ⅱ型21例。比较3组患者的手术时间,术中出血量、透视次数、骨折愈合时间及并发症情况。术后3 d采用视觉模拟评分(visual analogue scale,VAS)进行疼痛程度评价,末次随访采用Mayo肘关节功能评分标准进行肘关节功能评价。结果:3组病例手术时间、术中透视次数、术后VAS、软组织激惹情况比较,差异有统计学意义(P<0.05)。A、C组患者在手术时间、术中透视次数优于B组(P<0.05);C组在术后VAS、术后软组织激惹情况优于B组(P<0.05)。3组末次随访Mayo肘关节功能评分比较,差异有统计学意义(P<0.05),A、C组均高于B组(P<0.05)。结论:较之传统的双皮质置钉方式,克氏针髓内置钉和带孔克氏针张力带固定,操作简单,固定牢靠,软组织激惹少,手术并发症少,效果满意。Objective To compare the clinical effect of three types of Kirschner wire tension band for olecranon fracture.Methods The clinical data of 64 patients with olecranon fracture treated by Kirschner wire tension band fixation from March 2016 to May 2020 were retrospectively analyzed.Among them,19 patients were treated with intramedullary K-wires fixation(group A)including 8 males and 11 females with an average of(48.2±18.3)years old,3 patients were typeⅠ,and 16 patients were typeⅡaccording to Mayo classification;20 patients were treated with transcortical K-wires fixation(group B)including 13 males and 7 females with an average of(43.5±20.4)years old,3 patients were typeⅠand 17 patients were typeⅡaccording to Mayo classification;25 patients were treated with perforated Kirschner wire(group C)including 15 males and 10 females with an average of(55.2±17.5)years old,4 patients were typeⅠand 21 patients were typeⅡaccording to Mayo classification.The operative time,intraoperative blood loss,times of Intraoperative fluoroscopy,fracture healing time and complications of 3 groups were compared.At the final follow-up,elbow function was assessed using the Mayo Elbow Function Scale.Results There were differences in operative time,intraoperative fluoroscopy times,postoperative VAS and soft tissue irritation among the three groups(P<0.05).The operative time,intraoperative fluoroscopy times in group A and C was better than that in group B.The postoperative VAS score,skin irritability in group C was better than that of group B.The difference was statistically significant on Mayo elbow function score at the final follow-up among three groups(P<0.05),the scores of group A and C were higher than that of group B.Conclusion Compared with transcortical K-wires screw fixation,both intramedullary K-wires screw fixation and perforated Kirschner wire fixation,which can significantly reduce the occurrence of soft tissue irritation,reduce surgical complications and shorten the operation time.

关 键 词：尺骨鹰嘴 骨折 克氏针张力带 

分 类 号：R683.41[医药卫生—骨科学]