两种内固定治疗老年骨质疏松性尺骨鹰嘴骨折的临床对比  

Clinical comparison of two types of internal fixation for the treatment of osteoporotic olecranon fractures in the elderly

作　　者：杨杰 苏忠良 Yang Jie;Su Zhongliang(Department of Orthopedics,Wenzhou People′s Hospital,Wenzhou 325000,China)

机构地区：[1]温州市人民医院骨科,温州325000

出　　处：《中华手外科杂志》2023年第6期490-494,共5页Chinese Journal of Hand Surgery

基　　金：温州市科技局项目(Y2020415)。

摘　　要：目的比较带孔克氏针张力带和鹰嘴解剖型钢板治疗老年骨质疏松性尺骨鹰嘴骨折的临床疗效。方法自2017年5月至2020年4月我院行带孔克氏针张力带或鹰嘴解剖型钢板治疗老年骨质疏松性尺骨鹰嘴患者51例,采用带孔克氏针张力带固定(A组)25例、鹰嘴解剖型钢板(B组)26例。记录并对比两组患者手术时间、透射次数、术中出血量、术后疼痛评分、骨愈合时间、内固定松动、软组织激惹及末次随访Broberg-Morrey评分等,并行统计学检验,P<0.05表示差异有统计学意义。结果研究对象均获得随访,时间15~25个月,平均(20.3±4.6)个月。带孔克氏针张力带组(A组)在手术时间、术中出血量、骨愈合时间等指标上均好于解剖型钢板组(B组),且差异有统计学意义(P<0.05)。两组在术后疼痛评分、内固定松动、软组织激惹、末次随访Broberg-Morrey评分的差异均无统计学意义(P>0.05)。结论与鹰嘴解剖型钢板相比,带孔克氏针张力带不仅减少手术创伤,而且有助于老年骨质疏松性尺骨鹰嘴骨折的骨愈合。同时带孔克氏针在不增加手术并发症的基础上,获得与钢板一样的关节功能,故老年尺骨鹰嘴骨折患者术前内固定选择时可优先考虑。Objective To compare the clinical efficacy of prespecified perforated Kirschner wire tension band and olecranon anatomical plate in the treatment of elderly osteoporotic olecranon fracture of ulna.Methods A retrospective case-control study was conducted to analyze the clinical data of 51 elderly patients with osteoporotic olecranon who underwent fracture internal fixation in our hospital from May 2017 to April 2020.25 cases were fixed with a perforated Kirschner wire tension band(Group A)and 26 cases were fixed with olecranon anatomical plate(Group B).The operation time,fluoroscopy times,intraoperative bleeding volume,postoperative visual analogue score(VAS),fracture union time,internal fixation loosening,soft tissue irritation and Broberg-Morrey score of the last follow-up were recorded and compared between the two groups,and statistical tests were carried out.P<0.05 indicates a statistically significant difference.Results All patients were follow-up for 15 to 25 months with an average of(20.3±4.6)months.The index such as operation time,fluoroscopy times,intraoperative bleeding volume and fracture union time of the prespecified perforated Kirschner wire(group A)were better than those of the anatomical plate group(group B),and the difference was statistically significant(P<0.05).There was no significant difference between the two groups in the internal fixation loosening,soft tissue irritation,postoperative VAS and Broberg-Morrey score at the last follow-up(P>0.05).Conclusion Compared with the olecranon anatomical plate,the prespecified perforated Kirschner wire tension band can not only reduce the surgical trauma,but also contribute to the bone union of osteoporotic olecranon fracture in the elderly.At the same time,the prespecified perforated Kirschner wire can obtain the same joint function as the olecranon anatomical plate without increasing surgical complications.Therefore,in the selection of preoperative internal fixation for elderly patients with olecranon fracture of the ulna,the prespecified perforated

关 键 词：肘关节 骨折固定术 内 尺骨 

分 类 号：R687.3[医药卫生—骨科学]