新型张力带系统治疗尺骨鹰嘴骨折疗效研究

The Effect of A New Tension Band System for Olecranon Fractures

目的通过比较不同内固定方式治疗尺骨鹰嘴骨折的疗效,探讨新型张力带系统的临床应用价值。方法选择2016年3月至2019年3月于我院骨科行手术治疗的279例尺骨鹰嘴骨折患者,按内固定方式分为钢丝克氏针张力带固定组、锁定接骨板固定组及新型张力带系统固定组,各93例。比较三组患者围手术期相关指标、术后肘关节功能和临床疗效。结果新型张力带系统固定组患者手术时间、术中出血量、术后住院时间及骨折愈合时间均明显少于钢丝克氏针张力带固定组及锁定接骨板固定组,而术后肘关节功能评分及治疗总有效率均明显高于其他两组(P<0.05)。三组患者随访12~14个月,术后均无切口感染或不愈合等并发症发生。术后12个月锁定接骨板固定组出现1例骨折不愈合。三组均无骨化性肌炎、创伤性关节炎等严重并发症发生。结论新型张力带系统治疗尺骨鹰嘴骨折具有操作简单、固定牢固、无需二次手术、安全等优势,有助于术后肘关节功能恢复,值得临床推广应用。

Objective To compare the efficacy of different internal fixation treatments and further to explore the clinical value of the new tension band system for olecranon fractures.Methods A total of 279 olecranon fractures cases admitted from March 2016 to March 2019 in our hospital were selected and divided into 3 groups according to the method of internal fixation,with 93 cases for each group,and performed steel wire-Kirschner wire-tension band internal fixation(as group A),locking-plate internal fixation(as group B)and a new tension band system internal fixation(as group C)respectively.The peri-operative index,post-operative elbow joint function scores and outcomes were compared among the three groups.Results Among three goups,the operation time,intra-operative bleeding volume,post-operative hospital stays and fracture healing time were the least,and the post-operative elbow function score and clinical effective rate were the highest in the group C,and all the differences were remarkable(P<0.01).All cases were followed up for 12 to 14 months without infection and non-healing of incision after the surgery.Fracture nonunion was found in one case of the group B 12 months after the surgery.There was no serious complication such as ossifying myositis and traumatic arthritis in the three groups.Conclusion The internal fixation of the new tension band system is a simple and safe treatment for olecranon fracture with advantages of firm fixation,no-need secondary operations,improving elbow joint function recovery and less medical expenditure,and it is worthy of clinical promotion.