缝线Nice结张力带结合拉力螺钉固定简单横形尺骨鹰嘴骨折疗效分析

The effect of suture Nice knot tension band combined with lag screw fixation for simple transverse olecranon fracture

目的 探讨缝线Nice结张力带结合拉力螺钉固定简单横形尺骨鹰嘴骨折效果。方法选取2017年1月~2020年2月本院23例简单横行尺骨鹰嘴骨折采用缝线Nice结张力带结合拉力螺钉固定患者,其中Mayo ⅡA型14例,ⅢA型3例,肱骨髁间粉碎骨折行尺骨鹰嘴横形截骨手术6例。记录骨愈合、患肢功能恢复和并发症情况。结果 患者获12~28个月、平均(17.5±2.7)个月随访,无螺钉断裂和退钉刺激产生明显不适症状,骨折均愈合,愈合时间平均(2.3±0.5)个月。术后3个月和1年,肘关节平均屈伸范围为(103.5±22.0)°和(127.1±34.0)°,平均旋前为(72.2±7.0)°和(80.8±7.5)°,平均旋后为(70.9±6.7)°和(78.2±8.0)°,与术前比较差异有统计学意义(P<0.05);末次随访Mayo肘关节评分为(90.7±8.3)分,优良率91.30%,内固定取出率为26.1%,其中需要取出率为4.35%。结论 缝线Nice结张力带结合拉力螺钉固定简单横形尺骨鹰嘴骨折方法简便,关节功能恢复较快、较好,并发症少,内固定取除率较低。

Objective To investigate the effect of the suture Nice knot tension band combined with lag screw fixation for simple transverse olecranon fracture. Methods From January 2016 to December2020, 23 cases of simple transverse olecranon fracture were fixed with suture Nice knot tension band and lag screw. There were 14 cases of Mayo type ⅡA and Mayo 3 cases of type ⅢA, as well as 6 cases of olecranon transverse osteotomy for comminuted fracture of intercondylar humerus. Elbow flexion and extension motion were started on the second day after operation. The fracture healing, limb function recovery and complications were recorded. Results All patients were followed up for 12 to 28 months, with an average follow-up of(17.5±2.7) months. There were no screw breakage and obvious discomfort caused by screw withdrawal stimulation. All the fractures healed, the average healing time was(2.3±0.5) months. At 3 months and 1 year postoperatively, the average flexion and extension range of elbow joint were(103.5±22.0) ° and(127.1±34.0) °, respectively. The average pronation range were(72.2±7.0) ° and(80.8±7.5) °, respectively. The average supination range were(70.9±6.7) °and(78.2±8.0) °,There were statistical difference between before operation and 3 months and 1 year after operation(P<0.05). At the last follow-up, the Mayo elbow performance score averaged was(87.7±8.3), the excellent and good rate was 91.3%, the removal rate of internal fixation was 26.1%, of which, the required removal rate of internal fixation was 4.35%.Conclusions Suture Nice knot tension band and lag screw fixation for simple transverse olecranon fracture has the advantages of simple performance, rapid and satisfactory functional recovery of elbow joint, lest complications and lower removal rate of internal fixation.