两种张力带治疗尺骨鹰嘴骨折的比较研究

Comparative study of two kinds of tension band in the treatment of olecranon fracture of ulna

目的探讨拉力螺钉缝线张力带与传统方法治疗尺骨鹰嘴骨折的效果。方法我科自2016年1月至2020年6月收治63例简单横行尺骨鹰嘴骨折患者,采用张力带内固定治疗,按固定方式不同分为克氏针钢丝张力带组(A组)38例和拉力螺钉缝线张力带组(B组)25例。两组患者术前一般资料比较,差异无统计学意义(P>0.05)。比较骨折愈合、并发症、肘关节活动范围恢复和患肢功能恢复等情况,采用Mayo肘关节评分(Mayo elbow performance score,MEPS)和Quick-DASH方法进行主观和客观标准评价。结果所有患者术后随访12~28个月,平均(18.4±4.2)个月,骨折均愈合。A组的内固定断裂发生率、内固定需要取除率和内固定取出率高于B组,分别为15∶0、1∶20和4∶33,差异具有统计学意义(P<0.05)。而两组的骨折愈合时间、肘关节屈伸范围、前臂旋前和旋后范围、MEPS和Quick-DASH评分等比较,分别为2.31±0.40∶2.13±0.34、149.52±8.82∶151.52±9.06、83.91±4.91∶86.02±5.05、84.91±4.92∶85.44±4.86、91.06±6.07∶92.31±4.87和17.71±1.35∶17.48±1.38,差异均无统计学意义(P>0.05)。结论拉力螺钉缝线张力带治疗尺骨鹰嘴骨折,具有手术并发症少、内植物取出率低的优点,值得推广。

Objective To explore the effect of lag screw suture tension band and traditional method in the treatment of olecranon fracture of ulna.Methods Sixty-three patients with simple transverse olecranon fracture were treated in our department from January 2016 to June 2020.They were treated with tension band internal fixation.According to different fixation methods,they were divided into 38 cases in Kirschner wire tension band group(group A)and 25 cases in tension band group with lag screw suture tension band group(Group B).There was no significant difference in general data between the two groups(P>0.05).The fracture healing,complications,recovery of elbow range of motion and recovery of affected limb function were compared.Mayo elbow performance score(MEPS)and Quick-DASH were used for subjective and objective evaluation.Results All the patients were follow-up for 12 to 28 months,with an average of(18.4±4.2)months.All the fractures achieved healing.The incidence of fracture of internal fixation,the rate of necessity of internal fixation removal and the rate of internal fixation removal in group A were higher than those in group B,which were 15∶0,1∶20 and 4∶33 respectively(P<0.05).The fracture healing time,elbow flexion and extension range,forearm pronation and supination range,MEPS and Quick-DASH score of the two groups were 2.31±0.40∶2.13±0.34,149.52±8.82∶151.52±9.06,83.91±4.91∶86.02±5.05,84.91±4.92∶85.44±4.86,91.06±6.07∶92.31±4.87 and 17.71±1.35∶17.48±1.38,respectively.There was no significant difference(P>0.05).Conclusion The tension band with lag screw suture in the treatment of olecranon fracture has the advantages of less surgical complications and low removal rate of implant,which is worthy of popularization.