关节面塌陷的尺骨鹰嘴横形骨折应对策略  

Coping strategies for transverse olecranon fracture with articular surface collapse

作　　者：郑冲[1] 谢子康[1] 王斌[1] 彭立波[1] 高益[1] 周祺[1] 瞿玉兴[1] 沈鹏飞[1] ZHENG Chong;XIE Zikang;WANG Bin;PENG Libo;GAO Yi;ZHOU Qi;QU Yuxing;SHEN Pengfei(Orthopedics Department,Changzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Changzhou 213003,China)

机构地区：[1]南京中医药大学附属常州市中医医院骨科,江苏常州213003

出　　处：《临床医学研究与实践》2024年第26期74-77,共4页Clinical Research and Practice

摘　　要：目的探讨关节面塌陷的尺骨鹰嘴横形骨折的固定方法,评估张力带钢丝技术的可靠性。方法回顾性分析2015年6月至2021年6月本院32例选用张力带钢丝技术治疗的关节面塌陷的尺骨鹰嘴横形骨折患者的临床资料。记录患者的手术时间、随访时间、骨折愈合时间、并发症发生情况、肘关节屈伸活动度及肘关节活动功能。结果手术时间为40~60 min,平均(45.0±8.6)min。所有患者均获得随访,随访时间12~18个月,平均(14.2±1.8)个月,骨折均获得临床愈合,愈合时间9~12周,平均(10.2±1.2)周。随访期间未发生感染、内固定失效、骨折移位及关节面再塌陷情况,有1例患者在术后6个月出现了退针并引起皮肤激惹,但此时骨折已愈合,予以取出内固定。所有患者在随访期间内均取出内固定。末次随访时,关节活动范围为100°~135°,平均(115.0°±8.6°);Mayo肘关节功能评分(MEPS)为(92.15±5.12)分,其中优30例,良2例。结论张力带钢丝技术治疗关节面塌陷的尺骨鹰嘴横形骨折可以获得满意的临床效果,克氏针可对塌陷的关节面进行有效支撑。Objective To explore the fixation method of transverse olecranon fracture with articular surface collapse,and to evaluate the reliability of tension strip steel wire technique.Methods The clinical data of 32 patients with transverse olecranon fracture with articular surface collapse treated by tension strip steel wire technique in our hospital from June 2015 to June 2021 were retrospectively analyzed.The operation time,follow-up time,fracture healing time,occurrence of complications,elbow flexion and extension activity and elbow function were recorded.Results The operation time was 40-60 min,with an average of(45.0±8.6)min.All patients were followed up for 12-18 months,with an average of(14.2±1.8)months.All fractures healed clinically,and the healing time was 9-12 weeks,with an average of(10.2±1.2)weeks.There were no infection,internal fixation failure,fracture displacement and joint surface collapse occurred during the follow-up period.One patient had needle withdrawal and skin irritation at 6 months after operation,but the fracture had healed and the internal fixation was removed.All patients were removed internal fixation during the follow-up period.At the last follow-up,the range of joint motion was 100°-135°,with an average of(115.0°±8.6°);the Mayo Elbow Performance Score(MEPS)was(92.15±5.12)points,30 cases were excellent,and 2 cases were good.Conclusion Tension strip steel wire technique can achieve satisfactory clinical efficacy in the treatment of transverse olecranon fracture with articular surface collapse,and kirschner wire can effectively support the collapsed articular surface.

关 键 词：尺骨鹰嘴骨折 关节面塌陷 横形骨折 张力带钢丝技术 内固定 

分 类 号：R687.3[医药卫生—骨科学]