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不同方式固定尺骨鹰嘴骨折的病例对照研究
Hits: 2252   Download times: 1199   Received:May 09, 2014    
作者Author单位UnitE-Mail
陈一衡 CHEN Yi-heng 温州医科大学附属第二医院骨科, 浙江 温州 325000 Department of Orthopaedics, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China  
陈广军 CHEN Guang-jun 温州医科大学附属第二医院骨科, 浙江 温州 325000 Department of Orthopaedics, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China  
周飞亚 ZHOU Fei-ya 温州医科大学附属第二医院骨科, 浙江 温州 325000 Department of Orthopaedics, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China  
李士 LI Shi 温州医科大学附属第二医院骨科, 浙江 温州 325000 Department of Orthopaedics, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China  
宋永焕 SONG Yong-huan 温州医科大学附属第二医院骨科, 浙江 温州 325000 Department of Orthopaedics, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China  
高伟阳 GAO Wei-yang 温州医科大学附属第二医院骨科, 浙江 温州 325000 Department of Orthopaedics, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China  
李志杰 LI Zhi-jie 温州医科大学附属第二医院骨科, 浙江 温州 325000 Department of Orthopaedics, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China  
陈星隆 CHEN Xing-long 温州医科大学附属第二医院骨科, 浙江 温州 325000 Department of Orthopaedics, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China drchenxinglong@126.com 
期刊信息:《中国骨伤》2014年27卷,第11期,第891-895页
DOI:10.3969/j.issn.1003-0034.2014.11.002


目的: 比较采用克氏针加张力带钢丝、空心拉力螺钉及解剖型钢板3种不同内固定方式治疗尺骨鹰嘴骨折的疗效差异.

方法: 回顾自2010年1月至2012年1月共82例采用不同内固定方式治疗的尺骨鹰嘴骨折患者.采用张力带固定组35例(A组),男19例,女16例;年龄32~49岁,平均(43.6±8.7)岁;骨折按Colton分型,Ⅰ型5例,ⅡA型3例,ⅡB型19例,ⅡC型8例,ⅡD型0例.空心拉力螺钉固定组20例(B组),男13例,女7例;年龄27~50岁,平均(41.5±9.3)岁;骨折按Colton分型,Ⅰ型4例,ⅡA型4例,ⅡB型12例,ⅡC型0例,ⅡD型0例.解剖型钢板固定组27例(C组),男15例,女12例;年龄30~55岁,平均(38.2±6.2)岁;骨折按Colton分型,Ⅰ型0例,ⅡA型0例,ⅡB型4例,ⅡC型13例,ⅡD型10例.比较各组骨折愈合时间、肘关节功能恢复情况及并发症.采用Broberg-Morrey评分系统评价3组肘关节功能.

结果: 患者术后均获随访,时间8~24个月,平均15个月,C组较A、B组骨折愈合时间长.术后肘关节屈伸、旋转活动度A、B组优于C组;根据Broberg-Morrey评分系统进行疗效评价,A、B组疗效优于C组.解剖型钢板固定组2例发生创口感染,6例有明显的局部异物感,1例骨折延迟愈合,1例异位骨化.张力带固定组和空心拉力螺钉固定组无创口感染,发生内固定松动失效分别为3例和2例,出现骨折延迟愈合分别为2例,皮肤滑囊形成及针尾外露破溃分别为6例和1例.

结论: 3种不同内固定方式对尺骨鹰嘴骨折的固定各有优缺点,应根据具体骨折类型选用合适的内固定方式.
[关键词]:尺骨骨折  骨折固定术,内  肘关节  病例对照研究
 
Case-control study on therapeutic effects of different fixation methods for the treatment of olecranon fracture
Abstract:

Objective: To evaluate the clinical effects by comparing three different fixation Methods: tension band,hollow lag screw and anatomical plate.

Methods: From January 2010 to January 2012,82 patients with olecranon fractures who underwent surgical treatments were followed-up. All the patients were divided into three groups:tension band fixation group(group A),hollow lag screw fixation group(group B),anatomical plate fixation(group C). In group A,there were 35 patients,including 19 males and 16 females,ranging in age from 32 to 49 years old,with an average of(43.6±8.7) years old,and the patients were treated with tension band fixation. According to Colton classification,there were 5 cases of typeⅠ,3 cases of type ⅡA,19 cases of type ⅡB,and 8 cases of type ⅡC in group A. Among 20 patients in group B,there were 13 males and 7 females,ranging in age from 27 to 50 years old,with an average of (41.5±9.3) years old. The patients in group B were treated with hollow lag screw fixation. According to Colton classification,there were 4 cases of typeⅠ,4 cases of typeⅡA,and 12 cases of type ⅡB in group B. In group C,there were 27 patients totally,including 15 males and 12 females,ranging in age from 30 to 55 years old,with an average of(38.2±6.2) years old. The patients in group C were treated with anatomical plate fixation. According to Colton classification,there were 4 cases of typeⅡB,13 cases of typeⅡC,and 10 cases of type ⅡD in group C. The Fracture healing time,complications and functional recovery were retrospectively observed and recorded.

Results: All the patients were followed up,and the duration ranged from 8 to 24 months,with an average of 15 months. The average healing time of patients in group C was the longest among three groups. The flexion-extension and rotation activities of elbow joint in group B and C were better than that in group C. According to Broberg & Morrey score system,the therapeutic effects of patients in group A and B were better than that of group C. In group C,2 patients had incision infections,6 patients complained of foreign body sensation,1 patient got a delayed fracture healing,and 1 patient had the heterotopic ossification. There were no occurrences of incision infections in group A and B;internal fixation loosening occurred in 3 patients in group A and 2 patients in group B;delayed fracture healing occurred in 2 patients in group A and 2 patients in group B;and skin bursa formation occurred in 6 patients in group A and 1 patient in group B.

Conclusion: All the three ways are effective methods for the treatment of olecranon fractures. Fixation methods should be selected depending on the type of fracture.
KEYWORDS:Ulna fractures  Fracture fixation,internal  Elbow joint  Case-control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:陈一衡,陈广军,周飞亚,李士,宋永焕,高伟阳,李志杰,陈星隆.不同方式固定尺骨鹰嘴骨折的病例对照研究[J].中国骨伤,2014,27(11):891~895
英文格式:CHEN Yi-heng,CHEN Guang-jun,ZHOU Fei-ya,LI Shi,SONG Yong-huan,GAO Wei-yang,LI Zhi-jie,CHEN Xing-long.Case-control study on therapeutic effects of different fixation methods for the treatment of olecranon fracture[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(11):891~895
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