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新型带孔克氏针张力带治疗成人尺骨鹰嘴骨折的病例对照研究

[Case-control study on a new Kirschner wire tension band with hole in the treatment of adult olecranon fractures in adults].

作者信息

Dong Xiao-Min, Yang Jie, Wang Chao-Nan, Hu Jin, Huang Fei-Ri, Fu Jia-Xing, Su Zhong-Liang

机构信息

Department of Orthopaedics, Wenzhou People' s Hospital, Wenzhou 325000, Zhejiang, China.

Department of Orthopaedics, Wenzhou People' s Hospital, Wenzhou 325000, Zhejiang, China;

出版信息

Zhongguo Gu Shang. 2018 Jun 25;31(6):534-537. doi: 10.3969/j.issn.1003-0034.2018.06.010.

Abstract

OBJECTIVE

To compare the efficacy of Kirschner wire tension band with hole and common Kirschner wire tension band in the treatment of olecranon fractures in adults, so as to guide the selection of clinical surgical procedures.

METHODS

From July 2011 to October 2015, a total of 49 patients with olecranon fractures underwent open reduction and fixation with Kirschner wire tension band, which were retrospectively analyzed. Of the 49 patients, 21 patients(group A) were treated with Kirschner wire tension band with hole, including 12 males and 9 females, with an average age of(37.6 ±8.2) years old;28 patients(group B) were treated with common Kirschner wire, including 18 males and 10 females, with an average age of(38.9±7.3) years old. There were no statistically significant differences between the two groups in general data. The differences of operative duration, frequency of radiation, fracture healing time, complications and postoperative elbow function scores between the two groups were observed and analyzed by parallel statistical analysis.

RESULTS

In group A, the operative duration was(60.4±10.7) min, the average number of radiation times was (12.5±2.9); in group B, the operative duration was (62.3±11.8) min, and the average radiation times was(13.7±3.8); there was no significant difference in operative time and radiation times between the two groups (P >0.05). In group A, the fracture healing time was (13.2±2.6) weeks without K-wire migration, skin irritation and other complications; and fracture healing time in group B was(14.6±1.8) weeks with complications(K-wire migration in 6 cases, skin irritation in 7 cases, internal fixation failure in 2 cases);the fracture healing time of group A was shorter than that in group B. Evaluation of elbow joint function in two groups of patients after operation showed that in group A, pain score was 41.0±3.5, movement function score was 18.0±2.1, stability score was 9.0±0.8, daily activities score was 18.0±4.3, the total average score was 87.0±7.8; and in group B, the pain score was 39.0±5.6, movement function score was 17.0±3.2, the stability score was 8.0±2.4, daily activities score was 16.0±5.2, the total average score was 83.0±10.7. There were no statistically significant in the scores between the two groups.

CONCLUSIONS

Compared with ordinary Kirschner wire, the treatment of olecranon fracture with Kirschner tension band with hole can shorten the time of fracture healing, significantly reduce the occurrence of complications, and do not affect the recovery of postoperative function, which is suitable for clinical use.

摘要

目的

比较带孔克氏针张力带与普通克氏针张力带治疗成人尺骨鹰嘴骨折的疗效,以指导临床手术方式的选择。

方法

回顾性分析2011年7月至2015年10月期间49例行切开复位克氏针张力带内固定治疗的尺骨鹰嘴骨折患者。49例患者中,21例(A组)采用带孔克氏针张力带治疗,其中男12例,女9例,平均年龄(37.6±8.2)岁;28例(B组)采用普通克氏针治疗,其中男18例,女10例,平均年龄(38.9±7.3)岁。两组一般资料比较差异无统计学意义。采用平行对照统计分析观察并比较两组手术时间、透视次数、骨折愈合时间、并发症及术后肘关节功能评分的差异。

结果

A组手术时间为(60.4±10.7)min,平均透视次数为(12.5±2.9)次;B组手术时间为(62.3±11.8)min,平均透视次数为(13.7±3.8)次,两组手术时间及透视次数比较差异无统计学意义(P>0.05)。A组骨折愈合时间为(13.2±2.6)周,未出现克氏针松动、皮肤刺激等并发症;B组骨折愈合时间为(14.6±1.8)周,出现并发症(克氏针松动6例,皮肤刺激7例,内固定失败2例),A组骨折愈合时间短于B组。两组患者术后肘关节功能评价显示,A组疼痛评分为41.0±3.5,运动功能评分为18.0±2.1,稳定性评分为9.0±0.8,日常生活活动评分为l8.0±4.3,总平均分87.0±7.8;B组疼痛评分为39.0±5.6,运动功能评分为17.0±3.2,稳定性评分为8.0±2.4,日常生活活动评分为16.0±5.2,总平均分83.0±10.7,两组评分差异无统计学意义。

结论

与普通克氏针相比,带孔克氏针张力带治疗尺骨鹰嘴骨折可缩短骨折愈合时间,显著减少并发症的发生,且不影响术后功能恢复,适合临床应用。

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