预断式带孔克氏针和普通克氏针治疗老年骨质疏松性尺骨鹰嘴骨折的疗效比较  

Comparison of clinical efficacy between pre-cut perforated Kirschner wire and conventional Kirschner wire in the treatment of elderly osteoporotic olecranon fractures of the ulna

作　　者：杨杰 苏忠良 刘文斌 黄子淮 Yang Jie;Su Zhongliang;Liu Wenbin;Huang Zihuai(Depurtment of Onhopedics,Weuzhou People's Hospial,Wenzhou 325099,China)

机构地区：[1]温州市人民医院骨科,温州325099

出　　处：《中华手外科杂志》2024年第4期302-306,共5页Chinese Journal of Hand Surgery

摘　　要：目的研究比较预断式带孔克氏针和普通克氏针张力带治疗骨质疏松性尺骨鹰嘴骨折的疗效.方法我科自2015年5月至2019年6月行内固定手术治疗老年骨质疏松性尺骨鹰嘴患者共55例,采用预断式带孔克氏针治疗(A组)23例,Mayo分型Ⅰ型9例、Ⅱ型14例.采用普通克氏针张力带治疗(B组)32例,Mayo分型Ⅰ型13例、Ⅱ型19例.分别对比两组的透视次数、手术时间、术后视觉模拟评分(VAS)、骨折愈合时间、内固定松动、术中出血量、软组织激惹及Broberg-Morrey评分等,统计学检验P<0.05表示差异有统计学意义.结果术后55例患者均获得随访,时间17~24个月,平均(20.1±4.2)个月.在内固定松动、软组织激惹等指标上预断式带孔克氏针(A组)均优于普通克氏针张力带组(B组),且差异有统计学意义(P<0.05).在透视次数、手术时间、骨折愈合时间、术中出血量、术后视觉模拟评分(VAS)及末次随访Broberg-Morrey评分上,两组的差异均无统计学意义(P>0.05).结论相比既往的普通克氏针张力带,预断式带孔克氏针不仅降低了皮肤激惹和内固定松动的发生率,而且不增加手术创伤,最终获得良好的术后关节功能,比较适用于老年骨质疏松性尺骨鹰嘴骨折的治疗.Objective To study and compare the clinical efficacy of pre-cut perforated Kirschner wire and conventional Kirschner wire tension band in the treatment of osteoporotic olecranon fractures of the ulna.Methods From May 2015 to June 2019,a total of 55 elderly patients with osteoporotic olecranon of the ulna were treated by internal fixation surgery.23 cases were treated withpre-cut Kirschner wire with holes(Group A),with 9 cases classified as typeⅠand 14 cases as typeⅡaccording to the Mayo classification.32 cases were treated with conventional Kirschner wire tension band(Group B),with 13 cases classified as typeⅠand 19 cases as typeⅡaccording to Mayo classification.The fluoroscopy frequency,surgical time,postoperative visual analogue score(VAS),fracture healing time,internal fixation loosening,intraoperative bleeding,soft tissue irritation,and Broberg-Morrey score between the two groups were compared.P<0.05 indicated a statistically significant difference.Results All 55 patients were follow-up for a period of 17 to 24 months with an average of(20.1±4.2)months after surgery.In terms of indicators such as internal fixation loosening and soft tissue irritation,the pre-cut perforated Kirschner wire(Group A)was superior to the conventional Kirschner wire tension band group(Group B),and the difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups in terms of fluoroscopy frequency,surgical time,fracture healing time,intraoperative bleeding volume,postoperative VAS,and last follow-up Broberg-Morrey score(P>0.05).Conclusion Compared with the previous conventional Kirschner wire tension band,the pre-cut Kirschner wire with holes not only reduces the incidence of skin irritation and internal fixation loosening,but also does not increase surgical trauma,ultimately achieving good postoperative joint function.It is more suitable for the treatment of elderly osteoporotic olecranon fractures of the ulna.

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]