尺骨鹰嘴骨折-脱位手术治疗的疗效分析

Analysis on the effectiveness of surgical treatment of olecranon fracture-dislocation

目的探讨手术治疗尺骨鹰嘴骨折-脱位的效果，对手术方式和术中注意事项进行分析。方法采用手术治疗20例鹰嘴骨折-脱位，14例采用尺骨解剖钢板固定，6例使用张力带，5例在内固定后发现仍不稳定再加用外固定架固定。结果20例获随访15～30个月（平均24个月）。末次随访时肘关节功能Broberg＆Morrey评分：优6例，良5例，一般6例，差3例。15例出现关节异位骨化表现（75％），严重2例，中度5例，轻度8例。结论依据鹰嘴骨折一脱位类型与损伤机制选择适当的手术方式治疗，有利于鹰嘴形态和力线以及肘部稳定性的恢复，减少术后并发症发生。术后异位骨化发生率很高。应当早期干预。

Objective To investigate the effectiveness of surgical treatment of olecranon fracture-dislocation and analyze the surgical approach and intraoperative considerations. Methods Twenty patients with olecranon fracture-dislocation were treated by operation, 14 with ulnar anatomical plate fixation, 6 with tension band, 5 with external fixation as internal fixation was still unstable. Results All of 20 cases were all followed up for 15-30 months （mean, 24 months）. The final follow-up results, Broberg and Morrey rating system： excellent in 6 cases, good in 5 cases, the general in 6 cases, poor in 3 cases. F/fteen cases with elbow heterotopic ossification （75%）, and severe in 2 cases, moderate in 5 cases, mild in 8 cases. Conclusion To select the appropriate surgical approach based on olecranon fracture-dislocation types and mechanisms of injury is conducive to restore olecranon shape and line of force, and enhance the stability of the elbow, reduce postoperative complications. As a high incidence of postoperative heterotopic ossification, early intervention should be adopted.