双微型锁定钢板治疗尺骨鹰嘴骨折的疗效观察

Clinical observation of double mini locking plate in the treatment of olecranon fracture

目的:探讨双微型锁定钢板治疗尺骨鹰嘴骨折的临床疗效。方法:自2017年3月至2020年5月,采用双微型锁定钢板治疗19例尺骨鹰嘴骨折患者,其中男12例,女7例;年龄20~75(40.50±7.62)岁;左侧10例,右侧9例。19例患者均为新鲜闭合骨折且不合并尺骨冠状突骨折、肘关节脱位等损伤。记录患者骨折愈合时间及并发症情况,并于术前、术后12个月采用Mayo肘关节功能评分标准(Mayo elbow performance score,MEPS)进行临床疗效评价。结果:19例患者术后均获得随访,时间12~17(13.51±3.17)个月。术后所有骨折获得骨性愈合,时间2~6(3.77±1.24)个月,未发生内固定断裂、螺钉松动、感染、内固定激惹、异位骨化、肘关节僵硬等并发症。术后12个月患侧肘关节MEPS评分(91.26±3.87)分与术前(56.18±9.56)分比较差异有统计学意义(P<0.05);按照Mayo肘关节功能评分标准,结果优11例,良7例,中1例。结论:采用双微型锁定钢板治疗尺骨鹰嘴骨折,手术切口小,骨折固定可靠,术后可早期行肘关节功能锻炼,术后内固定对皮肤激惹小,肘关节功能恢复满意,是一种可靠的固定方法。

Objective:To investigate the clinical effect of double mini-locking plates in the treatment of ulna olecranon fractures.Methods:From March 2017 to May 2020,19 patients with olecranon fractures were treated with double mini-locking plates,including 12 males and 7 females,aged from 20 to 75 years old with an average of(40.50±7.62)years old;10 patients had the injuries on the left side and 9 patients on the right side.All the 19 patients were fresh closed fractures without ulnar coronoid process fracture,elbow dislocation and other injuries.The fracture healing time and complications were recorded,and the clinical efficacy was evaluated by Mayo elbow performance score(MEPS)before operation and 12 months after operation.Results:All the 19 patients was followed up,and the duration ranged from 12 to 17 months with an average of(13.51±3.17)months.Postoperative follow-up showed all fractures healed.Fracture healing time ranged from 2 to 6 months,with an average of(3.77±1.24)months.There was no internal fixation fracture,screw loosening,infection,internal fixation irritation,heterotopic ossification,elbow stiffness and other complications occurred.The MEPS score of affected elbow at 12 months after operation was 91.26±3.87,which was significantly different from that before operation 56.18±9.56(P<0.05);according to Mayo Elbow function score standard,11 cases were excellent,7 cases were good,and 1 case was fair.Conclusion:It is a reliable fixation method to treat olecranon fracture with double mini locking plate.The incision lengh is small and the fracture fixation is reliable.Elbow joint function exercise can be performed early after operation.Postoperative internal fixation has less skin irritation and satisfactory elbow joint function recovery.