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不同类型 Horne 和 Tanzer 尺骨鹰嘴骨折的长期预后。

Long-term outcomes after different types of Horne and Tanzer olecranon fractures.

机构信息

Departments of Orthopaedics, Skane University Hospital, 205 02, Malmo, Sweden.

Department of Clinical Sciences Malmo (IKVM), Lund University, Malmo, Sweden.

出版信息

Arch Orthop Trauma Surg. 2021 May;141(5):709-716. doi: 10.1007/s00402-020-03453-z. Epub 2020 Apr 23.

Abstract

BACKGROUND

It is unclear whether the outcomes differ after different Horne and Tanzer types of olecranon fractures.

MATERIALS AND METHODS

We evaluated 40 men and 55 women with isolated olecranon fractures, journals and radiographs from fracture event. The fractures were classified according to Horne and Tanzer. After a mean 19 years after the fracture events, we evaluated subjective, clinical and radiographic outcomes, using the uninjured arms as controls.

RESULTS

95% of patients with type I fractures reported, at follow-up, no differences between the elbows, 80% with type II fractures and 95% with type III fractures (p = 0.43). The three types of fractures had no differences in elbow range of motion or hand grip strength (when comparing injured and uninjured arms) and the proportions of individuals with radiographic elbow degenerative changes or joint space reduction were no different (all p > 0.05). Individuals with elbow degenerative changes had no inferior subjective elbow function compared to individuals with normal radiographs (p = 0.66), in contrast to those with joint space reduction compared to individuals with normal radiographs (p < 0.001).

INTERPRETATION

All types of Horne and Tanzer olecranon fractures have favourable long-term outcome. Elbow joint space reduction is associated with inferior subjective elbow function while degenerative changes are not.

摘要

背景

目前尚不清楚不同 Horne 和 Tanzer 分型的尺骨鹰嘴骨折的预后是否存在差异。

材料和方法

我们评估了 40 名男性和 55 名女性的孤立性尺骨鹰嘴骨折患者,这些患者的病历和影像学资料均来自骨折发生时。根据 Horne 和 Tanzer 分型对骨折进行分类。在骨折发生后平均 19 年,我们评估了主观、临床和影像学结果,将健侧作为对照。

结果

95%的 I 型骨折患者在随访时报告两侧肘部无差异,80%的 II 型骨折患者和 95%的 III 型骨折患者(p=0.43)。三种类型的骨折在肘部活动范围或手握力方面(比较受伤和未受伤的手臂)没有差异,且影像学上肘关节退行性改变或关节间隙变窄的比例也没有差异(均 p>0.05)。与影像学正常的患者相比,有肘关节退行性改变的患者的主观肘部功能没有明显降低(p=0.66),而与影像学正常的患者相比,关节间隙变窄的患者的主观肘部功能明显降低(p<0.001)。

结论

所有类型的 Horne 和 Tanzer 尺骨鹰嘴骨折都有良好的长期预后。关节间隙变窄与主观肘部功能降低有关,而退行性改变则没有。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/443a/8049928/917a23727a8c/402_2020_3453_Fig1_HTML.jpg

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