Meldrum Alexander, Kwong Cory, Archibold Katherine, Cinats David, Schneider Prism
Division of Orthopaedic Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada.
Southern California Orthopaedic Institute, University of Los Angeles, Los Angeles, CA.
J Orthop Trauma. 2021 May 1;35(5):265-270. doi: 10.1097/BOT.0000000000001979.
This study reports on olecranon osteotomy implant removal rates, fixation types, and associated complications.
Multicentre case series.
Patients were identified through an electronic medical database at one Level 1 trauma center and three Level 2 trauma centers.
Two hundred thirty-five patients were identified through the database, of which 92 patients met inclusion criteria.
Patients underwent olecranon osteotomy for fixation of distal humerus fractures and the implant used was at the surgeon's discretion.
Implant removal rate.
Thirty-four of 92 (37.0%) patients underwent removal of implant from their olecranon osteotomy. Implant removal rates were as follows: 28 of the 63 patients for tension band wiring (TBW) (44.4%), 6 of the 18 patients for plates (33.3%), 0 of the 1 patient for cable-pin, and 0 of the 10 patients for osteotomies fixed with a screw fixation. Screw fixation was removed less frequently than TBW (P = 0.01). Screws were less commonly removed than all other fixation types (P = 0.01). TBWs (28/63) were more commonly removed than all other implants (6/29) (P < 0.05). The nonunion rate for olecranon osteotomies was 3.3%. TBWs (18/18) are more likely to be removed for implant irritation than plates. TBWs had an odds ratio of 3.29 for requiring implant removal if they were left >1 mm off of the olecranon tip.
In this study, 34 of the 92 (37%) patients undergoing an olecranon osteotomy for treatment of a distal humerus fracture required removal of olecranon implant. Screw fixation (0/10) was found to be removed less frequently than TBW fixation 28 of the 63 patients (44.4%).
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
本研究报告尺骨鹰嘴截骨术的植入物取出率、固定类型及相关并发症。
多中心病例系列研究。
通过一家一级创伤中心和三家二级创伤中心的电子医疗数据库识别患者。
通过数据库识别出235例患者，其中92例符合纳入标准。
患者接受尺骨鹰嘴截骨术以固定肱骨远端骨折，植入物的使用由外科医生自行决定。
植入物取出率。
92例患者中有34例（37.0%）接受了尺骨鹰嘴截骨术植入物取出术。植入物取出率如下：63例采用张力带钢丝固定（TBW）的患者中有28例（44.4%），18例采用钢板固定的患者中有6例（33.3%），1例采用缆钉固定的患者中0例，10例采用螺钉固定截骨术的患者中0例。螺钉固定取出的频率低于张力带钢丝固定（P = 0.01）。螺钉取出的频率低于所有其他固定类型（P = 0.01）。张力带钢丝固定（28/63）比所有其他植入物（6/29）更常被取出（P < 0.05）。尺骨鹰嘴截骨术的不愈合率为3.3%。与钢板相比，张力带钢丝固定（18/18）因植入物刺激更有可能被取出。如果张力带钢丝固定距离尺骨鹰嘴尖端>1 mm，则需要取出植入物的比值比为3.29。
在本研究中，92例接受尺骨鹰嘴截骨术治疗肱骨远端骨折的患者中有34例（37%）需要取出尺骨鹰嘴植入物。发现螺钉固定（0/10）取出的频率低于63例患者中的28例（44.4%）采用的张力带钢丝固定。
治疗性四级证据。有关证据水平的完整描述，请参阅作者指南。
