雪橇板技术治疗尺骨鹰嘴骨折的临床观察

Clinical observation of olecranon sled for the treatment for olecranal fracture

目的:探讨鹰嘴雪橇板固定技术治疗尺骨鹰嘴骨折的临床疗效。方法:2017年3月采用鹰嘴雪橇板固定技术治疗4例尺骨鹰嘴骨折患者,其中男2例,女2例;年龄40,46,47,72岁;左侧3例,右侧1例;均为摔伤引起。骨折均为横行、斜行或轻度关节面压缩骨折。伤后1～3 d内进行手术。观察患者的手术时间、术中出血量、并发症及术后肘关节屈伸和前臂功能恢复情况,采用VAS评分评价疼痛缓解程度,并采用Mayo肘关节功能评分评价肘关节功能恢复情况。结果:至2018年9月,4例获得随访,时间18个月。手术时间40～60 min,术中出血量20～40 ml,术后无切口并发症。所有患者术后4个月随访时骨折愈合。末次随访时屈肘140°～150°,伸肘0°～过伸10°,屈伸活动范围140°～160°,MEPS评分为100分。患者活动时无明显疼痛感,VAS评分为0分。结论:鹰嘴雪橇板的低切迹设计和一体化设计避免了张力带和钢板常见的内固定物激惹现象,操作简单,对于简单和轻度粉碎的鹰嘴骨折是一种理想的内固定方式,但不适用于严重粉碎的鹰嘴骨折。

Objective:To explore clinical effect of olecranon sled in treating olecranal fracture.Methods:Four patients with olecranal fracture treated by olecranon sled in March 2017,including 2 males and 2 females,age of 40,46,47,72 years old,3 patients on the left side and 1 patient on the right side.All patients were caused by falling down.Fracture were transverse,oblique and slightly compressive articular surface fracture.The time from injury to operation ranged from 1 to 3 days.Operative time,blood loss,complications and flexion and extension of elbow joint,and function of forearm were observed,VAS score was used to evaluate relieve degree of pain,and Mayo score was applied to assess recovery of elbow function.Results:Four patients were followed up until September 2018.Operative time ranged from 40 to 60 min,blood loss was for 20 to 40 ml,and no complications occurred.All fracture were healed at 4 months after operation.Elbow flexion was for 140°to 150°,extension of elbow was from 0°and extend to 10°,activity of flexion and extension ranged from 140°to 160°,MEPS score was 100.No pain occurred during doing activity,and VAS score was 0.Conclusion:Low-profile design and integrated design of olecranon sled could avoid irritation of tension band and plate,and it is a simple and ideal internal fixation method for simple and mildly comminuted olecranon fracture,which is not suitable for severely comminuted olecranon fracture.