尖齿开口钩钢板治疗尺骨鹰嘴骨折疗效观察

EFFECTIVENESS OF SHARP TEETH HOOK PLATE FOR TREATMENT OF OLECRANON FRACTURES

目的通过与克氏针张力带和锁定接骨板比较,探讨尖齿开口钩钢板治疗尺骨鹰嘴骨折的疗效。方法2011年1月-2015年4月,手术治疗尺骨鹰嘴骨折32例。其中12例采用裁剪而成的尖齿开口钩钢板治疗（试验组）,20例采用克氏针张力带或锁定接骨板治疗（对照组）。两组患者性别、年龄、骨折侧别、骨折分型、受伤至手术时间等一般资料比较,差异均无统计学意义（P〉0.05）,具有可比性。记录两组患者骨折愈合时间和并发症发生情况;术后1年,按臂-肩-手功能障碍评分（DASH）行患者主观功能评估,按Mayo肘关节评分（MEPS）进行客观功能评定,采用疼痛视觉模拟评分（VAS）评价肘关节疼痛程度,并测量肘关节屈伸活动范围。结果术后患者切口均Ⅰ期愈合,无神经、血管损伤等并发症发生。患者均获随访,随访时间12~36个月,平均18个月。患者骨折均愈合,两组骨折愈合时间比较,差异无统计学意义（P〉0.05）。术后试验组无内固定物松动,对照组2例克氏针松动;两组并发症发生率比较差异无统计学意义（P〉0.05）;试验组DASH、MEPS、VAS评分和肘关节屈曲活动范围均优于对照组,比较差异有统计学意义（P〈0.05）;但两组肘关节后伸活动范围比较,差异无统计学意义（P〉0.05）。结论尖齿开口钩钢板克服了克氏针张力带易松动和锁定接骨板对肱三头肌腱压迫等缺陷,是治疗尺骨鹰嘴骨折的一种有效方法。

Objective To investigate the effectiveness of sharp teeth hook plate by cutting for the treatment of olecranon fractures by comparison with Kirschner wire tension belt and locking plate. Methods Between January 2011 and April 2015, 32 cases of olecranon fractures were treated. Fracture was fixed with sharp teeth hook plate by cutting in 12 cases（trial group） and with Kirschner wire tension belt or locking plate in 20 cases（control group）. There was no significant difference in gender, age, side and type of fracture, and time from injury to operation between 2 groups（P0.05）. The healing time of fractures and complications were recorded. At 1 year after operation, the subjective function results were evaluated according to Disability of Arm, Shoulder, and Hand（DASH） score, and objective function results by Mayo Elbow Score（MEPS）; visual analogue scale（VAS） was used for elbow joint pain, and range of motion of flexion and extension of elbow joint was measured. Results All incisions healed by first intention, with no vascular and nerve injuries. All patients were followed up 12-36 months with an average of 18 months. All fractures healed, and there was no significant difference in the healing time between 2 groups（P0.05）. Loosening of Kirschner wire occurred in 2 cases of control group, but no loosening of internal fixation was observed in trial group after operation. There was no significant difference in the incidence of complications between 2 groups（P0.05）. The DASH, MEPS, VAS score, and range of motion of flexion in trial group were superior to those in control group, showing significant differences（P0.05） at 1 year after operation. There was no significant difference in range of motion of extension between 2 groups（P0.05）. Conclusion Sharp teeth hook plate for treatment of olecranon fractures overcomes the shortcomings that Kirschner wire tension is easy to slide and locking plate has a compression effect on triceps tendon, so it has good effectiveness.