经尺骨鹰嘴截骨入路治疗肘关节恐怖三联征的效果

Effect of Olecranon Osteotomy Approach in the Treatment of Terror Triad of Elbow

目的:探讨经尺骨鹰嘴截骨入路(OOA)治疗肘关节恐怖三联征的效果。方法:按照随机数字表法将2018年2月-2021年1月中信惠州医院收治的89例肘关节恐怖三联征患者分为两组,两组均接受手术治疗,B组44例经外侧入路,A组45例经OOA,观察两组骨折恢复情况、肘关节功能、关节功能活动度及并发症发生率。结果:随访1年后,失访7例,其中A组失访4例,B组失访3例,最终纳入病例数为82例,B组和A组各41例。A组优良率为70.73%,高于B组的48.78%(P<0.05)。术后3、6、12个月,两组疼痛、运动功能、稳定性、日常活动、肘关节屈曲及伸展评分均高于术前,且A组均高于B组,差异均有统计学意义(P<0.05)。A组并发症发生率为4.88%,B组为9.76%,两组比较差异无统计学意义(P>0.05)。结论:经OOA治疗肘关节恐怖三联征可更好地促进骨折恢复,改善肘关节功能,提高关节活动度且不增加并发症发生率。

Objective:To explore the effect of olecranon osteotomy approach(OOA)in the treatment of terror triad of elbow.Method:According to the random number table method,89 patients with terror triad of elbow in CITIC Huizhou Hospital from February 2018 to January 2021 were divided into two groups.Two groups were given surgical treatment,group B had 44 cases via lateral approach,and group A had 45 cases via OOA.The fracture recovery,elbow joint function,joint functional mobility and incidence of complications of two groups were observed.Result:After 1 year after follow-up,7 cases were lost to follow-up,including 4 cases in group A and 3 cases in group B.Finally,82 cases were included,41 cases in group B and 41 cases in group A.The excellent and good rate was 70.73%in group A,which was higher than 48.78%in group B(P<0.05).At 3,6 and 12 months after operation,the scores of pain,motor function,stability,daily activities,elbow flexion and extension in two groups were higher than those before operation,and the scores in group A were higher than those in group B,the differences were statistically significant(P<0.05).The incidence of complications in group A was 4.88%,and group B was 9.76%,there was no significant difference between two groups(P>0.05).Conclusion:Terror triad of elbow treated by OOA can better promote fracture recovery,improve elbow joint function and increase joint mobility without increasing the incidence of complications.