两种内固定治疗尺骨鹰嘴骨折的疗效比较

Comparison effect of two kinds of internal fixation on ulnar olecranon fracture

目的比较金属骨针张力带内固定与尺骨近端背侧钢板内固定治疗尺骨鹰嘴骨折的疗效。方法将41例尺骨鹰嘴骨折患者按照治疗方式的不同分为金属骨针组(采用金属骨针张力带内固定治疗,21例)和钢板组(采用尺骨近端背侧钢板内固定治疗,20例)。比较两组手术情况、骨折愈合情况。采用疼痛VAS评分评估疼痛改善情况,采用改良Mayo评分评价肘关节功能恢复情况。结果患者均获得随访,时间12~14个月。手术时间、切口长度和术中透视次数金属骨针组短(少)于钢板组(P<0.001)。疼痛VAS评分两组术后3个月均低于术后2周(P<0.001),术后2周、3个月两组比较差异均无统计学意义(P>0.05)。改良Mayo评分术后3、10个月金属骨针组均高于钢板组(P<0.05)。末次随访时,两组骨折均愈合,无复位丢失、钢丝断裂、螺钉断裂等情况发生。结论与尺骨近端背侧钢板相比,金属骨针张力带内固定治疗尺骨鹰嘴骨折手术方法简单、有效,手术切口小,张力带固定强度可靠,患者术后功能恢复较快。

Objective To compare the effect of tension band internal fixation with metal bone needle and internal fixation with dorsal plate of proximal ulna for treatment of ulnar olecranon fracture.Methods The 41 patients with ulnar olecranon fracture were divided into two groups according to different treatment methods:metal needle group(metal needle tension band internal fixation,21 cases)and plate group(dorsal plate of proximal ulna internal fixation,20 cases).The operation situation and fracture healing situation were compared between two groups.The pain VAS was used to evaluate the pain improvement,and the improved Mayo score was used to evaluate the recovery of elbow function.Results All patients were followed up for 12~14 months.The operative time,incision length and intraoperative fluoroscopic times of metal needle group were shorter(less)than those of plate group(P<0.001).The pain VAS:at 3months after surgery,which were lower than those at 2 weeks after surgery(P<0.001);there were no significant differences between two groups at 2 weeks,3 months postoperation(P>0.05).The modified Mayo score:at 3,10months after surgery,they were higher in the metal needle group than the plate group(P<0.05).At the last followup,both groups were healed without loss of reduction,wire fracture,screw fracture.Conclusions For the treatment of olecranon fracture,compared with the dorsal plate of proximal ulna internal fixation,metal bone needle tension band internal fixation has the advantages of simple operation,small incision and fast postoperative functional recovery of the patients.