前后联合入路手术治疗经鹰嘴肘关节骨折脱位患者的临床分析

Clinical Analysis of Combined Anterior and Posterior Approach for the treatment of Fracture and Dislocation of the Olecranon Joint

目的:探讨前后联合入路手术治疗经鹰嘴肘关节骨折脱位患者的临床疗效。方法:选取2015年1月至2017年3月36例经鹰嘴肘关节骨折脱位患者为研究对象,随机数字表法均分为对照组和研究组各18例,对照组采用肘关节后侧入路切复内固定术治疗,研究组则采用前后联合入路手术治疗,观察两组手术一般情况、骨折愈合情况、肘关节功能恢复情况(Broberg-Morrey功能评分)、术后并发症发生情况。结果:两组手术时间相较无明显差异(P>0.05);研究组术中出血量(26.49±3.28)m L、骨折愈合时间(6.09±1.18)周较对照组明显少、短,差异有统计学意义(P<0.05);术后6个月研究组骨折愈合率100.00%较对照组77.78%明显高,差异有统计学意义(χ2=4.500,P<0.05),术前两组Broberg-Morrey评分相较无明显差异(P>0.05);术后两组Broberg-Morrey评分明显升高,且术后研究组BrobergMorrey评分(78.82±4.88)分、(85.34±5.36)分、(93.32±6.08)分升高的幅度较对照组明显,差异有统计学意义(P<0.05);术后研究组并发症发生率27.78%较对照组72.22%明显低(检验值=4.685,P<0.05)。结论:前后联合入路手术治疗经鹰嘴肘关节骨折脱位患者的临床疗效明确,有临床推广应用价值。

Objective:To discuss the clinical efficacy of combined anterior and posterior approach surgery in the treatment of transolecranon fracture-dislocation of the elbow.Methods:36 patients with transolecranon fracture-dislocation of the elbow treated in the hospital from January 2015 to March 2017 were selected as study subjects,and they were divided into the control group and the study group with 18 cases in each group by the random number table method.The control group was treated by elbow posterior open reduction and internal fixation while the study group was treated by combined anterior and posterior approach surgery.The general situation of surgery,fracture healing,recovery of elbow function(Broberg-Morrey function score)and the incidence of complications in the two groups after surgery were observed.Results:There was no significant difference in the surgical time between the two groups(P>0.05).The intraoperative blood loss and fracture healing time of the study group[(26.49±3.28)mL,(6.09±1.18)weeks]were less or shorter than those of the control group(P<0.05).The fracture healing rate of the study group in 6 months after surgery was higher than that of the control group(100.00%vs 77.78%)(χ2=4.500,P<0.05).There was no significant difference in Broberg-Morrey scores between the two groups before surgery(P>0.05).After surgery,Broberg-Morrey scores of the two groups increased significantly,and the Broberg-Morrey scores of study group after surgery[(78.82±4.88),(85.34±5.36),(93.32±6.08)]were significantly higher than those of the control group(P<0.05).The incidence of complications in the study group after surgery was significantly lower than that in the control group(27.78%vs 72.22%)(Test value=4.685,P<0.05).Conclusion:The clinical efficacy of combined anterior and posterior approach for the treatment of fracture and dislocation of the olecranon joint is clear,and it has clinical application value.