Zhang Jun, Chen Ding-Shuang, Liu Dong-Xu, Li Feng
Department of Orthopaedics, Wenzhou Traditional Chinese and Western Medicine Hospital, Wenzhou 325000, Zhejiang, China.
Zhongguo Gu Shang. 2020 Jul 25;33(7):602-8. doi: 10.12200/j.issn.1003-0034.2020.07.003.
To compare clinical effects of common Kirschner wire, anatomical plate and perforated Kirschner wire in treating olecranon fracture.
From March 2014 to May 2017, clinical data of 79 patients with olecranon fracture treated with different internal fixation was retrospectively analyzed. Among them, 26 patients treated with common Kirschner wire (group A), including 19 males and 7 females aged from 23 to 51 years old with an average of (37.2±9.6) years old;11 patients were typeⅠ, and 15 patients were typeⅡ according to Mayo classification. Twenty eight patients were treated with olecroanon anatomical plate internal fixation, including 16 males and 12 females aged from 25 to 52 years old with an average of (36.6±8.9) years old;10 patientswere typeⅠ and 18 patients were typeⅡ according to Mayo classification. Twenty five patients were treated with perforated Kirschner wire, including 13 males and 12 females aged from 26 to 51 years old with an average of (38.2±9.2) years old;9 patients were typeⅠand 16 patients were typeⅡ according to Mayo classification. Operation time, intraoperatve blood loss, fracture healing time and postoperative complications among three groups were compared; VAS score at 1 week after operation was used to evaluate pain relief, Broberg-Morrey function score of elbow joint at the final follow up was applied to evaluate clinical effect.
Seventy nine patients were followed up from 13 to 23 months with an average of (18.3±4.5) months. Operation time, intraoperatve blood loss, fracture healing time in group A were (82.9±19.7) min, (113.5±32.3) ml, (4.2±0.6) months respectively;in group B were(101.2±24.5) min, (150.2±39.5) ml, (4.6±0.8) months respectively;in group C were (83.3±18.7) min, (119.3±34.3) ml, (4.1±0.5) months respectively. Operation time, intraoperatve blood loss, fracture healing time in group A and group C were better than that of group B(<0.05). Five patients in group A occurred ineffective internal fixation, other groups did not occurred;9 patients in group A occurred skin irritability, 3 patients in group B and no patient occurred in group C; there were statistical differences in complications among three groups (<0.05). There were no differences in VAS score at 1 week after operation and Broberg-Morrey function score of elbow joint at the final follow-up among three groups (>0.05).
Common Kirschner wire has more complications; anatomical plate has greater surgical trauma and long fracture healing time;while perforated Kirschner wire was not only benefit for fracture union with less trauma, but also could reducing the incidence of postoperative complications, and it is the appropriate method for patients with olecranon fracture.
比较普通克氏针、解剖钢板及带孔克氏针治疗尺骨鹰嘴骨折的临床效果。
回顾性分析2014年3月至2017年5月采用不同内固定方法治疗的79例尺骨鹰嘴骨折患者的临床资料。其中，26例采用普通克氏针治疗（A组），男19例，女7例，年龄23～51岁，平均（37.2±9.6）岁；按Mayo分型，Ⅰ型11例，Ⅱ型15例。28例采用尺骨鹰嘴解剖钢板内固定治疗（B组），男16例，女12例，年龄25～52岁，平均（36.6±8.9）岁；按Mayo分型，Ⅰ型10例，Ⅱ型18例。25例采用带孔克氏针治疗（C组），男13例，女12例，年龄26～51岁，平均（38.2±9.2）岁；按Mayo分型，Ⅰ型9例，Ⅱ型16例。比较三组的手术时间、术中出血量、骨折愈合时间及术后并发症；采用术后1周VAS评分评估疼痛缓解情况，末次随访时采用肘关节Broberg-Morrey功能评分评估临床疗效。
79例患者均获随访，随访时间13～23个月，平均（18.3±4.5）个月。A组手术时间、术中出血量、骨折愈合时间分别为（82.9±19.7）min、（113.5±32.3）ml、（4.2±0.6）个月；B组分别为（101.2±24.5）min、（150.2±39.5）ml、（4.6±0.8）个月；C组分别为（83.3±18.7）min、（119.3±34.3）ml、（4.1±0.5）个月。A组和C组的手术时间、术中出血量、骨折愈合时间均优于B组（<0.05）。A组有5例出现内固定失效，其他组未出现；A组有9例出现皮肤刺激症状，B组有3例，C组无；三组并发症比较差异有统计学意义（<0.05）。三组术后1周VAS评分及末次随访时肘关节Broberg-Morrey功能评分比较差异无统计学意义（>0.05）。
普通克氏针并发症较多；解剖钢板手术创伤大，骨折愈合时间长；带孔克氏针不仅创伤小有利于骨折愈合，还可降低术后并发症发生率，是治疗尺骨鹰嘴骨折患者的合适方法。
