经尺骨鹰嘴截骨入路治疗AO-C型肱骨远端骨折患者的效果

Transulnar Olecranon Osteotomy in Patients with AO-C Type Distal Humeral Fractures

目的:探讨AO-C型肱骨远端骨折患者予以经尺骨鹰嘴截骨入路的疗效。方法:选取2020年5月—2022年5月顺昌县医院收治的60例AO-C型肱骨远端骨折患者为研究对象,按随机数表分为对照组(30例,经肱三头肌内外侧入路治疗)、观察组(30例,经尺骨鹰嘴截骨入路治疗),观察两组手术指标、视觉模拟评分法(visual analogue scale,VAS)评分、肘关节恢复情况及并发症等指标水平变化情况。结果:观察组手术时间、术中出血量均优于对照组,差异有统计学意义(P<0.05);术后3个月,观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。术后6个月,观察组Mayo评分高于对照组,差异有统计学意义(P<0.05);术后6个月,观察组肘关节屈曲、旋后、背伸、旋前等活动度均大于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论:相较于经肱三头肌内外侧入路,临床治疗AO-C型肱骨远端骨折患者中予以经尺骨鹰嘴截骨入路,能缩短手术时间,减小术中出血量与疼痛度,提升肘关节功能;还可控制并发症,具有显著的临床效果。

Objective:To investigate the clinical effect of AO-C type distal humeral fracture by transulnar olecranon osteotomy.Method:From May 2020 to May 2022,60 patients with AO-C type distal humeral fracture treated in Shunchang County Hospital were selected and randomly divided into control group(n=30,treated by medial-lateral of triceps brachii approach)and observation group(n=30,treated by transulnar olecranon osteotomy),the surgical indexes,visual analogue scale(VAS)score,recovery of elbow joint and complications were observed.Result:The operation time and intraoperative blood loss in the observation group were better than those in the control group,the differences were statistically significant(P<0.05).Three months after surgery,VAS score of observation group was lower than control group,the difference was statistically significant(P<0.05).Six months after surgery,Mayo score of observation group was higher than control group,the difference was statistically significant(P<0.05).Six months after surgery,the range of motion of elbow joint flexion,supination,dorsi extension and pronation in the observation group were greater than those in the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Compared with the medial-lateral of triceps brachii approach,transulnar olecranon osteotomy can shorten the operation time in patients with AO-C type distal humeral fractures,reduce the amount of bleeding and pain,it can promote the quick recovery of elbow joint function,reduce the complications effectively,and obtain the remarkable clinical effect.