Terstappen Afra L E, Joosse Pieter, van Dijke Cornelis F, Mirck Boj, van den Brand Johan G H
Departments of Trauma Surgery, and.
Radiology, Northwest Clinics, Alkmaar, the Netherlands.
J Orthop Trauma. 2020 Jul;34(7):e239-e244. doi: 10.1097/BOT.0000000000001728.
To assess the long-term functional results of both simple and comminuted olecranon fractures treated with tension band wiring (TBW).
Retrospective.
Level 1 trauma center.
PATIENTS & INTERVENTION: Between 2004 and 2014, 178 fractures in 178 patients >16 years of age were treated with TBW for a unilateral olecranon fracture.
Subjective functionality was tested with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Mayo Elbow Performance Index (MEPI).
Fifty percent of our cohort were lost to follow-up leaving 89 for review. A total of 51.7% had a comminuted fracture. Mean follow-up time was 7.1 years. Reoperation rate for implant removal was 84%. The total median DASH score was 0.83. Eighty-five patients (95.5%) were rated excellent using the MEPI score. No significant difference in either score was found between the simple (SF) and the comminuted (CF) group. Median range of motion was flexion/extension: 145/-2 degrees, supination/pronation: 90/90 degrees. No clinically relevant difference in range of motion was found between the 2 groups.
We found no relevant differences in either subjective or objective functionality between patients with simple or comminuted olecranon fractures after fixation with TBW. Therefore, TBW seems to be an adequate and justifiable treatment modality for both simple and comminuted olecranon fractures.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
评估采用张力带钢丝固定术（TBW）治疗单纯性和粉碎性鹰嘴骨折的长期功能结果。
回顾性研究。
一级创伤中心。
2004年至2014年期间，178例16岁以上患者的178处单侧鹰嘴骨折采用TBW治疗。
采用手臂、肩部和手部功能障碍（DASH）问卷及梅奥肘关节功能指数（MEPI）测试主观功能。
我们的队列中有50%失访，剩余89例接受复查。共有51.7%为粉碎性骨折。平均随访时间为7.1年。植入物取出的再次手术率为84%。DASH总分中位数为0.83。采用MEPI评分，85例患者（95.5%）评定为优秀。单纯骨折组（SF）和粉碎骨折组（CF）在任何一项评分中均未发现显著差异。中位活动范围为屈曲/伸展：145°/-2°，旋后/旋前：90°/90°。两组之间在活动范围方面未发现临床相关差异。
我们发现，采用TBW固定后，单纯性或粉碎性鹰嘴骨折患者在主观和客观功能方面均无相关差异。因此，对于单纯性和粉碎性鹰嘴骨折，TBW似乎都是一种充分且合理的治疗方式。
治疗性四级证据。有关证据水平的完整描述，请参阅《作者须知》。
