克氏针钢丝张力带固定术治疗尺骨鹰嘴骨折48例疗效分析

Analysis of Therapeutic Effect of Kirschner Needle and Steel Wire Tension-band Fixation in Treatment of Olecranon Fracture

目的提高克氏针钢丝张力带固定尺骨鹰嘴骨折的疗效。方法回顾性分析研究48例克氏针钢丝张力带固定术治疗尺骨鹰嘴骨折,尺骨鹰嘴骨折Colton分型,Ⅰ型撕脱型15例,Ⅱ型斜型14例,Ⅲ型横型16例,TV型粉碎型2例,合并冠状突骨折1例。结果平均手术时间约30～45min,术后2～3日即行功能锻炼,术后12～14d行伤口拆线,术后随访1～6年,平均3.5年,肘关节功能HSS评价:优秀率达95.8%。术后并发症:克氏针退出1例,骨不愈合1例,创伤性关节炎1例,发生率为6.25%。结论克氏针张力带内固定术符合尺骨鹰嘴骨折解剖特点及损伤机制要求,具有操作简单、固定有效、早期功能锻炼、术后并发症少、费用低廉等优点,但是对于粉碎型骨折及尺骨冠状突骨折疗效差,应尽量避免使用。

Objective To discuss the therapeutic effect of the oleeranon fracture treated with kirschner needle and steel wire tension-band fixation. Methods The forty-eight cases with olecranon fracture treated with kirschner needle and steel wire tension-band fixation were analyzed and researched,according to the cohon typing of the the olecranon fracture：including Ⅰ vulsion type 15 cases;Ⅱ oblique type 14 cases; Ⅲhorizontal type 16 cases; Ⅳ crash type 2 cases;one case eonbined with coronal fracture. Results Mean operation time was about 30-45 min,funetional exercise performing postoperation was 2 -3 days, wound cure postoperation was 12- 14 days,the postoperation follow-up time was 1- 6 years,average time was 3.5 years, the outcome of the elbow joint function by HSS evaluation,excellent and good rate was 95.8% Postoperative complications： one case kirschner needle exit,one ease bony disunion and one case raumatic arthritis. Conclusion The olecranon fracture treated with kirsehner needle and steel wire tension-band fixation,it is consistent with the anatomy feature and injury mechanism of the olecranon process of ulna fracture,have many advantages,such as operation simple,fixation steady,few postoperative complications,can perform functional exercise early and cure cast low,but have poor effect on crash and coronal fracture,so should avoid to be used as far as possible.