空心钉张力带和解剖型钢板固定治疗MayoⅡa型尺骨鹰嘴骨折的临床疗效比较

Comparisonof hollow nail plus tentsion and anatomical plate in treatment for Mayo type Ⅱa Olecranon Fracture

目的比较空心钉张力带和解剖型钢板固定治疗MayoⅡa型尺骨鹰嘴骨折的临床疗效。方法2004-2010年筛选MayoⅡa型尺骨鹰嘴骨折患者62例,男36例,女26例,年龄18~42岁,平均28.64岁。分别采用空心钉张力带和解剖型钢板两种手术方式,其中空心钉张力带组27例（A组）,解剖型钢板35例（B组）,观察手术时间、出血量、骨折愈合时间、术后并发症以及肘关节HSS评分。结果随访时间20~24个月,平均21.8个月。A、B组两组手术时间分别为（74.50±4.32）min和（78.12±22.69）min,无明显差异。A组术中出血量（53.33±4.08）m L,B组（93.12±28.40）m L,P〈0.01,差异有统计学意义。A、B组两组术后愈合时间分别为（13.00±0.89）周和（13.50±0.93）周,差异无统计学意义。A组术后肘关节HSS评分（94.66±5.27）分,B组（82.87±9.62）分,P〈0.05,差异有统计学意义。并发症方面,两组均未出现内固定松动断裂、骨不连及局部感染,空心钉张力带组出现1例肘后异物感,解剖钢板组出现4例肘后异物感。结论尺骨鹰嘴骨折治疗以空心钉张力带为首选,手术简单,并发症低,效果确切。

[Objective ] To compare the clinical effects of Hollow Nail plus Tentsion and Anatomical plate in Treatment for Mayo type II a Olecranon Fracture. [Methods] 62 cases with Olecranon fractures including 36 males and 26 females, were treated with the Hollow Nail plus Tentsion （n =27, A group） and Anatomical plate （n =27, B group） from 2004-2010, aged from 18-42 years old （mean age was 28.64 years）. The data of the two group were col- lected for statistical analysis on the following aspects： Operation duration, blood loss, clinical healing time of frac- ture, postoperative implication and HSS Elbow-Performance Score. [Results ] All these patients were given a follow- up for a mean 21.8 months, between 20 to 24 months. The operation duration was （74.50±4.32） min in group A and （78.12±22.69） min in group B, showing no significant difference. According the blood loss, there were （53.33±4.08） mL in group A, which was significant less than group B （93.12±28.40） mL, P 〈0.01. The clinical healing time was （13.00±0.89） weeks in group A and （13.50±0.93） weeks in group B, showing no significant difference. The postoper- ation HSS Elbow-Performance Score in group A is （94.66±5.27）, which was significant higher than group B （82.87±9.62）, P 〈0.05. Accoring to the postoperation complication, there was 1 case of foreign body sensation in the Hollow Nail plus Tentsion group. In the other hand, there were 4 cases of foreign body sensation in the Anatomical plategroup. [ Conclusions ] In the treatment for Mayo type II a Olecranon Fracture, Hollow Nail plus Tentsion may be the best choice, which can fix exactly with a low incidence of complications.