Hackl M, Rausch V, Ries C, Müller L P, Wegmann K
Schwerpunkt für Unfall‑, Hand- und Ellenbogenchirurgie, Universitätsklinik zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Unfallchirurg. 2018 Nov;121(11):911-922. doi: 10.1007/s00113-018-0567-7.
Olecranon fractures represent a common elbow injury and they are usually treated operatively. Depending on fracture morphology conservative therapy can be considered in geriatric patients. When surgical treatment is performed the anatomical features of the proximal ulna have to be taken into consideration. Tension band wiring is considered a standard procedure for simple fractures and provides good clinical results. Plate osteosynthesis is indicated for more complex fracture patterns. Nowadays, many surgeons prefer plate fixation over tension band wiring even for simple fractures as it leads to a more stable fixation. Both methods frequently require hardware removal for persisting soft tissue irritation. The use of modern low-profile plates could reduce the need for implant removal due to better soft tissue coverage. The available clinical data regarding low-profile plates are promising but limited.
鹰嘴骨折是一种常见的肘部损伤,通常采用手术治疗。根据骨折形态,老年患者可考虑保守治疗。进行手术治疗时,必须考虑尺骨近端的解剖特征。张力带钢丝固定术被认为是治疗简单骨折的标准方法,并能取得良好的临床效果。钢板内固定适用于更复杂的骨折类型。如今,许多外科医生即使对于简单骨折也更倾向于钢板固定而非张力带钢丝固定,因为它能提供更稳定的固定。这两种方法都经常因持续的软组织刺激而需要取出内固定物。使用现代的薄型钢板由于能更好地覆盖软组织,可能会减少取出植入物的需求。关于薄型钢板的现有临床数据很有前景,但有限。