Chen Yi-heng, Chen Guang-Jun, Zhou Fei-Ya, Li Shi, Song Yong-Huan, Gao Wei-Yang, Li Zhi-Jie, Chen Xing-Long
Department of Orthopaedics, 2nd Affiliated Hospital of Wenzhou Medical University, Zhejiang, China.
Zhongguo Gu Shang. 2014 Nov;27(11):891-5.
To evaluate the clinical effects by comparing three different fixation methods: tension band, hollow lag screw and anatomical plate.
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 type I, 3 cases of type II A,19 cases of type II B, and 8 cases of type II C 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 type I, 4 cases of type II A, and 12 cases of type II B 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 type II B, 13 cases of type II C, and 10 cases of type II D in group C. The Fracture healing time, complications and functional recovery were retrospectively observed and recorded.
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.
All the three ways are effective methods for the treatment of olecranon fractures. Fixation methods should be selected depending on the type of fracture.
通过比较三种不同固定方法（张力带、空心拉力螺钉和解剖钢板）评估其临床效果。
对2010年1月至2012年1月接受手术治疗的82例尺骨鹰嘴骨折患者进行随访。所有患者分为三组：张力带固定组（A组）、空心拉力螺钉固定组（B组）、解剖钢板固定组（C组）。A组35例，男19例，女16例，年龄32～49岁，平均（43.6±8.7）岁，采用张力带固定治疗。按Colton分型，A组Ⅰ型5例，ⅡA 型3例，ⅡB型19例，ⅡC型8例。B组20例，男13例，女7例，年龄27～50岁，平均（41.5±9.3）岁，采用空心拉力螺钉固定治疗。按Colton分型，B组Ⅰ型4例，ⅡA 型4例，ⅡB型12例。C组共27例，男15例，女12例，年龄30～55岁，平均（38.2±6.2）岁，采用解剖钢板固定治疗。按Colton分型，C组ⅡB型4例，ⅡC型13例，ⅡD型10例。回顾性观察并记录骨折愈合时间、并发症及功能恢复情况。
所有患者均获随访，随访时间8～24个月，平均15个月。C组患者平均愈合时间在三组中最长。B组和C组肘关节屈伸及旋转活动度优于A组。按Broberg & Morrey评分系统，A组和B组患者治疗效果优于C组。C组有2例发生切口感染．6例主诉有异物感，1例骨折延迟愈合，1例发生异位骨化。A组和B组无切口感染发生；A组有3例、B组有2例发生内固定松动；A组和B组各有2例发生骨折延迟愈合；A组有6例、B组有1例发生皮肤滑囊形成。
三种方法均是治疗尺骨鹰嘴骨折的有效方法。应根据骨折类型选择固定方法。
