解剖锁定钢板结合3D打印模型治疗尺骨鹰嘴骨折的临床疗效

Clinical efficacy of anatomical locking plate combined with 3D printing model in the treatment of olecranon fracture

目的:观察解剖锁定钢板结合3D打印模型治疗尺骨鹰嘴骨折的临床疗效。方法:回顾性分析2017年1月至2020年12月我院收治的60例经X线或CT确诊的MayoⅡA和B型尺骨鹰嘴骨折患者的临床资料,根据手术方式不同,分为A、B、C 3组,每组20例。A组采用克氏针张力带内固定治疗,B组采用解剖锁定钢板治疗,C组采用解剖锁定钢板结合3D打印模型治疗,比较3组手术时间、术中出血量、术中透视次数、骨折愈合时间及术后内固定松动和皮肤激惹的并发症发生情况。术后3个月随访时采用Mayo评分评估功能情况。结果:60例患者均获得随访,平均随访时间(13.75±2.11)个月。A组和C组手术时间、术中出血量差异无统计学意义(P>0.05),均低于B组(P<0.05);3组骨折愈合时间差异无统计学意义(P>0.05);C组患者术中透视次数低于A、B组(P<0.05);术后3个月,C组患者Mayo评分优于A、B组(P<0.05)。3组并发症发生率比较差异有统计学意义(P<0.05)。结论:解剖锁定钢板结合3D打印模型治疗尺骨鹰嘴骨折能够提供更好的稳定性,术后并发症少,可明显改善肘关节功能,值得临床推广。

Objective:To investigate the clinical efficacy of anatomical locking plate combined with 3D printing model in the treatment of olecranon fracture.Methods:The clinical data of 60 patients with MayoⅡA and B olecranon fractures diagnosed by X ray or CT admitted to our hospital from Jan 2017 to Dec 2020 were retrospectively analyzed.They were divided into A,B and C groups according to different surgical methods,with 20 cases in each group.Group A was treated with Kirschner wire tension band,group B was treated with anatomical locking plate,and group C was treated with anatomical locking plate combined with 3D printing model.The operative time,intraoperative blood loss,intraoperative fluoroscopy times,fracture healing time and complications of loose internal fixation and skin irritation were compared among the three groups.Function was assessed by Mayo score at 3 months of follow-up.Results:All 60 patients were followed up for(13.75±2.11)months.The operative time and intraoperative blood loss in group A and C were lower than that in group B(P<0.05).There was no significant difference in fracture healing time among the three groups(P>0.05).The number of intraoperative fluoroscopy in group C was lower than that in groups A and B(P<0.05).At 3 months after surgery,the Mayo score in group C was better than that in groups A and B(P<0.05).There was statistical significance in the incidence of complications among the three groups(P<0.05).Conclusion:Anatomical locking plate combined with 3D printing model in the treatment of olecranon fracture can provide better stability and fewer postoperative complications,and significantly improve elbow function,which is worthy of clinical promotion.