克氏针张力带与解剖钢板治疗尺骨鹰嘴骨折的疗效分析

Comparision of Kirschner's Tension-band Fixation with Anatomical Plate Fixation in Treatment of Olecranal Fractures

目的：比较克氏针张力带与解剖钢板治疗尺骨鹰嘴骨折的疗效。方法：2006年8月至2014年8月采用克氏针张力带治疗尺骨鹰嘴骨折131例,Mayo分型：Ⅰ型10例,Ⅱ型68例,Ⅲ型53例。采用治疗解剖钢板治疗尺骨鹰嘴骨折125例,Mayo分型：Ⅰ型15例,Ⅱ型66例,Ⅲ型44例。结果：所有病例均获得平均18（10~38）个月的随访,MayoⅠ型、Ⅱ型中DASH、MEPS、VAS评分及肘关节活动度功能丧失的比较无统计学差异（P〉0.05）,MayoⅢ型中DASH、MEPS、VAS评分比较有统计学差异（P〈0.05）肘关节屈曲旋前旋后功能丢失的比较有统计学差异（P〈0.05）肘关节。肘关节伸展功能的丢失的比较没有统计学差异（P〉0.05）。MayoⅠ型中对比两组内固定物取出率无统计学差异（P〉0.05）,MayoⅡ型中对比两组内固定物取出率比较有统计学差异0（χ2=8.18,〉6.63,P〈0.01）,MayoⅢ型中对比两组内固定物取出率,行方差分析,无统计学差异（χ2=0.57,〈3.84,P〉0.05）。结论：克氏针张力带与解剖钢板在治疗MayoⅠ型,Ⅱ型尺骨鹰嘴骨折均能取得较好的临床疗效,但在MayoⅢ型中钢板组明显优于张力带组。在两组内固定物取出率的比较上,MayoⅠ型,MayoⅢ型骨折无明显差异,而MayoⅡ型骨折中钢板组内固定物取出率明显低于张力带组。

Objective:To compare Kirschner's tension-band fixation with the anatomical plate fixation in treatment of olecranal fractures.Methods:256patients with olecranal fractures from Aug.2006 to Aug.2014 had been divided into 2 groups in this study.One group of 131 cases treated with Kirschner's tension-band fixation had been classified into 10TypeⅠ cases,68TypeⅡ cases and 53TypeⅢ cases by the Mayo method.The other group of 125 cases treated with anatomical plate fixation had been classified into 15 Type Ⅰ cases,66TypeⅡ cases and 44 Type Ⅲ cases.Results:All the patients were followed up during an average of 18 months(10~38).There were no significant differences(P>0.05)in DASH,MEPS,VAS Scores and elbow motion function loss between the two groups concerning the cases with both TypeⅠandⅡ;meanwhile there existed statistical significances in DASH,MEPS,VAS Scores and elbow supination flexion function loss concerning the cases with Type Ⅲ(P <0.05).There was no statistical significance in the loss of elbow extension function(P>0.05).As for the rates of the fixture removal,there was no statistical difference in the TypeⅠcases between the two groups(P>0.05);however there was statistically significant difference in the TypeⅡ(χ2=8.18,>6.63,P<0.01);there was no significant difference in the TypeⅢ(χ~2=0.57,<3.84,P>0.05).Conclusion:Both the fixation methods can achieve acceptable effects in treatment of Type Ⅰ andⅡ olecranal fractures.However the anatomical plate fixation is much better than the Kirschner's tension-band fixation for the TypeⅢ cases.There is no significant difference in the removal rate of fixture between the two groups concerning Type Ⅰ and Ⅲ cases.However the removal rate in the TypeⅡ cases of the anatomical plate group is lower than the Kirschner group.