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鹰嘴骨折的张力带钢丝固定:不同构型克氏针的相对稳定性

Tension band wiring for olecranon fractures: relative stability of Kirschner wires in various configurations.

作者信息

Huang Tsan-Wen, Wu Chi-Chuan, Fan Kuo-Feng, Tseng I-Chuan, Lee Po-Cheng, Chou Ying-Chao

机构信息

Department of Orthopaedics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.

出版信息

J Trauma. 2010 Jan;68(1):173-6. doi: 10.1097/TA.0b013e3181ad554c.

DOI:10.1097/TA.0b013e3181ad554c
PMID:20065772
Abstract

BACKGROUND

To assess clinical and functional outcomes as well as the relative stability of various configurations of tension band wiring approaches for treating olecranon fractures, a retrospective cohort study was conducted.

METHODS

Seventy-seven consecutive adult patients with 78 olecranon fractures were treated using tension band wiring techniques in three different configurations. The configurations differed in the location of the ends of Kirschner wires with the following locations being used: in the proximal ulnar canal, through the anterior ulnar cortex, and in the distal ulnar canal.

RESULTS

Based on average follow-up of 2.76 years (range, 1.1-5.5 years), all three techniques achieved high union rates and low complication rates. However, the Kirschner wires in the first technique allowed proximal pin migration with elbow irritation as compared with the second and the third techniques (p = 0.001, 0.03, respectively).

CONCLUSIONS

Placement of the ends of Kirschner wires in the proximal ulnar canal should be avoided whenever possible. Because placement of the ends of Kirschner wires through the anterior ulnar cortex may produce serious complications as reported in medical literature, placement of the ends of Kirschner wires in the distal ulnar canal may be the most effective approach.

摘要

背景

为评估不同张力带钢丝固定方法治疗尺骨鹰嘴骨折的临床和功能结果以及相对稳定性,进行了一项回顾性队列研究。

方法

77例连续成年患者的78处尺骨鹰嘴骨折采用三种不同构型的张力带钢丝技术治疗。构型在克氏针末端位置不同,采用以下位置:尺骨近端髓腔、穿过尺骨前皮质、尺骨远端髓腔。

结果

基于平均2.76年(范围1.1 - 5.5年)的随访,所有三种技术均实现了高愈合率和低并发症率。然而,与第二种和第三种技术相比,第一种技术中的克氏针允许近端针移位并伴有肘部刺激(分别为p = 0.001,0.03)。

结论

应尽可能避免将克氏针末端置于尺骨近端髓腔。由于如医学文献所报道,将克氏针末端穿过尺骨前皮质可能产生严重并发症,将克氏针末端置于尺骨远端髓腔可能是最有效的方法。

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