数字骨科技术结合张力带钢丝在尺骨鹰嘴ⅡB型骨折中的应用

The Advantage of TBW in the Treat of Olecranon Fracture of Type ⅡB by Computer Simulaiton

目的 探讨数字骨科技术结合张力带钢丝（tension band wiring,TBW）在尺骨鹰嘴IIB型骨折治疗中的应用及与锁定加压钢板（locking compression plate,LCP）相比较有无优势.方法 自2009年6月至2012年3月共收治患者50 例,其中男性31 例,女性19 例;年龄23～57 岁,平均42.5 岁.骨折原因：以跌倒或车祸直接暴力伤为主.随机分为两组,A组采用LCP治疗,B组采用TBW治疗.比较两组在手术时间、透视次数、功能预后方面差异有无统计学意义.结果 A组手术时间95%可信区间为（74.44±14.46） min;B组手术时间95%可信区间为（60±11.82） min;P＜0.05,两组之间差异有统计学意义.A组透视次数95%可信区间为（6.48±1.75）次;B组透视次数95%可信区间为（4.17±1.63）次,P＜0.05,组间差异有统计学意义.A组功能优18 例,良5 例,差4 例,优良率85.1%;B组功能优14 例,良6 例,差3 例,优良率86.9%;组间差异采用卡方检验,P＞0.05,差异无统计学意义.远期两组的功能预后并无显著区别.结论 对于鹰嘴骨折IIB型中骨折块较细小、骨折线较多的特定类型,TBW也可以达到近似LCP的治疗效果,而且手术时间更短,透视次数更少,花费也相应更少.

Abstract：Objective The purpose of this study was to compare TBW and LCP in the treatment of the olecranon fracure type IIB by computer simulation. Methods A series of 50 patients（ 19 women and 31 men）with olecranon fractures caused by traffic accident or direct violence were treated over a period of 3 years（2009.6 -2012.3 ）. The patients＇ mean age at time of the operation was 42.5 （ range 23 to 57）. The patients were randomly divided into 2 groups ; LCP is used in group A, TBW in group B. The operation time, frequency of the fluoroscopy and outcome were compared between two groups. Results The 95 % confidence internals of the operation time was （ 7 4.4 4 ± 1 4.4 6 ） min in group A. The 9 5 % confidence internals was （ 6 0 ± 11.82） min in group B. There was a significant difference in opration time between the two groups （P 〈 0.05 ）. The frequency of the fluoroscopy in group A was（6.48 ± 1.75）. The frequency of the fluoroscopy in group B was（4.17 ± 1.63 ）. There was a significant difference in fluoroscopy between the two groups （ P 〈 0.05 ）. There was no difference in outcome between two groups. Conclusion TBW is more cost-effective than LCP in the special type fractures of the olecranon in the time of opera- tion and the frequency of the fluoroscopy.