张力带钢丝和钢板固定治疗MayoⅡA型鹰嘴骨折的效果比较

Comparison of effect of tension band wiring versus plate fixation in the treatment of Mayo IIA olecranon fractures

目的比较张力带钢丝(TBW)和钢板固定治疗MayoⅡA型鹰嘴骨折的临床效果。方法抽取2017年5月至2021年5月于新郑市人民医院接受治疗的MayoⅡA型鹰嘴骨折患者120例, 依据手术方案将其分为两组。张力带组60例行TBW固定, 钢板组60例行钢板固定。术后1年, 比较两组关节活动度、上肢功能评定量表(DASH)评分、肘关节功能Mayo评分及二次手术情况。结果术后1年复查X线, 两组患者骨折均愈合。术后1年, 钢板组屈伸活动度大于张力带组(t=3.030, P=0.003)。张力带组DASH评分高于钢板组(t=8.331, P=0.001), 钢板组Mayo评分高于张力带组(t=2.433, P=0.016)。骨折愈合1年内, 张力带组因种植体刺激行二次手术移除种植体8例, 钢板组行种植体移除3例。结论 TBW和钢板固定均适用于ⅡA型鹰嘴骨折治疗, 但TBW固定因种植体刺激行二次手术例数较多。

Objective To compare the effect of tension band wiring(TBW)and plate fixation(PF)in the treatment of Mayo II A olecranon fractures.Methods A total of 120 patients with MayoⅡA olecranon fractures who were treated in Xinzheng People’s Hospital from May 2017 to May 2021 were selected and divided into two groups according to the surgical plan.Sixty cases of tension band group were fixed with TBW and 60 cases of plate group were fixed with steel plates.One year after operation,the joint range of motion,disabilities of the arm,shoulder and hand(DASH)score,elbow joint function Mayo score,and second surgery of the two groups were compared.Results X-rays were reexamined one year after operation,and the fractures of the two groups healed.One year after surgery,the flexion and extension range of the plate group was greater than that of the tension band group(t=3.030,P=0.003).The DASH score of the tension band group was higher than that of the plate group(t=8.331,P=0.001),and the Mayo score of the plate group was higher than that of the tension band group(t=2.433,P=0.016).Within one year of fracture healing,8 patients of the tension band group underwent secondary implant removal due to implant stimulation,and 3 patients of the plate group underwent implant removal.Conclusions Both TBW and plate fixation are suitable for the treatment of type II A olecranon fractures,but there are many cases of TBW fixation that undergo secondary operations due to implant stimulation.