应用解剖型锁定板内固定联合克氏针张力带治疗尺骨鹰嘴骨折的病例对照研究

A Case-control Study on Treatment of Ulnar Olecranon Fracture with Anatomical Locking Plate Internal Fixation Combined with Kirschner Wire Tension Band

目的:探讨解剖型锁定板内固定术联合克氏针张力带治疗MayoⅡ、Ⅲ型尺骨鹰嘴骨折的可行性、安全性。方法:回顾2014-2017年60例(MayoⅡ、Ⅲ型)尺骨鹰嘴骨折的患者,34例患者接受解剖锁定钢板治疗(A组);26例患者接受解剖锁定钢板联合克氏针张力带治疗(B组)。比较两组手术出血量、术后血红蛋白浓度、手术时间、骨折愈合时间、出院时肘关节屈伸活动度、术后HSS评分及术后并发症发生状况。结果:A组手术出血量、手术时间、出院时肘关节后伸范围、术后1年HSS评分均显著低于B组(P<0.05);A组术后血红蛋白浓度高于B组,骨折愈合时间长于B组(P<0.05)。两组并发症发生率差异无统计学意义(P>0.05)。结论:在不稳定性尺骨鹰嘴骨折的治疗上,解剖型锁定钢板联合克氏针张力带治疗预后结局更好,具有可靠的应用价值。

Objective:To investigate the feasibility and safety of anatomical locking plate internal fixation combined with Kirschner wire tension band in the treatment of Mayo typeⅡandⅢulnar olecranon fractures.Method:From 2014 to 2017,60 patients(Mayo typeⅡandⅢ)with ulnar olecranon fracture were reviewed.34 patients were treated with anatomical locking plate(group A)and 26 patients were treated with anatomical locking plate combined with Kirschner wire tension band(group B).The amount of bleeding,hemoglobin concentration,operation time,fracture healing time,elbow flexion and extension activity at discharge,HSS score and complications after operation were compared between the two groups.Result:The amount of bleeding,operation time,elbow extension range at discharge and HSS score at 1 year after operation in group A were significantly lower than those in group B(P<0.05);the hemoglobin concentration in group A was higher than that in group B,and the fracture healing time was longer than that in group B(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:In the treatment of unstable olecranon fracture,anatomical locking plate combine with Kirschner wire tension band is better prognostic outcome and reliable application value.