Ankara Şehir Hastanesi Ortopedi ve Travmatoloji Kliniği, 06800 Çankaya, Ankara, Türkiye.
Jt Dis Relat Surg. 2021;32(1):85-92. doi: 10.5606/ehc.2021.75812. Epub 2021 Jan 6.
This study aims to compare clinically and functionally patients who had previously undergone tension band wiring (TBW) or plate fixation (PF) procedure due to the diagnosis of Mayo type 2A olecranon fracture in our clinic.
Data of 92 patients (51 males, 41 females; mean age 42.3±12.6 years; range, 16 to 75 years) operated on for olecranon fractures between January 2014 and December 2018 were recorded retrospectively. Forty-four patients received TBW and 48 patients received PF treatment. Their Disabilities of the Arm, Shoulder, and Hand (DASH) and Mayo scores and elbow range of motion (ROM) measurements were used for clinical and functional evaluations. Data including the time to return to work, revision rate, and follow-up time were also recorded.
The mean follow-up time was 38.2±17.2 months. Patients returned to work in 9.2±4.1 weeks in the TBW group and 7.8±3.6 weeks in the PF group (p=0.279). The revision rate was 14% in the TBW group and 2% in the PF group (p=0.335). The mean DASH score was 10.0±1.8 in the TBW group and 7.7±1.2 in the PF group (p=0.001). The mean Mayo score was 84.0±9.3 in the TBW group and 88.3±9.1 in the PF group (p=0.049). For elbow flexion-extension ROM, 4° of difference was measured in favor of the PF group (p=0.043). Mean Mayo score, mean DASH score, and mean flexion-extension ROM values were statistically significantly different between the two groups.
Both surgical techniques are suitable and reliable in the treatment of olecranon fractures. Although TBW treatment is low-cost and simple to apply, its biggest disadvantage is a high rate of secondary surgery for implant removal due to irritation of the skin.
本研究旨在比较在我院就诊的 Mayo 2A 型尺骨鹰嘴骨折患者行张力带钢丝（TBW）或钢板固定（PF）术后的临床和功能结果。
回顾性分析 2014 年 1 月至 2018 年 12 月期间因尺骨鹰嘴骨折接受手术的 92 例患者（男性 51 例，女性 41 例；平均年龄 42.3±12.6 岁；年龄范围 16~75 岁）的临床资料。44 例行 TBW 治疗，48 例行 PF 治疗。采用腕关节、手和肩部功能障碍（DASH）评分、Mayo 评分和肘屈伸活动度（ROM）测量评估临床和功能结果。记录包括重返工作时间、翻修率和随访时间等数据。
平均随访时间为 38.2±17.2 个月。TBW 组患者重返工作的时间为 9.2±4.1 周，PF 组为 7.8±3.6 周（p=0.279）。TBW 组翻修率为 14%，PF 组为 2%（p=0.335）。TBW 组 DASH 评分为 10.0±1.8，PF 组为 7.7±1.2（p=0.001）。TBW 组 Mayo 评分为 84.0±9.3，PF 组为 88.3±9.1（p=0.049）。PF 组在肘屈伸活动度方面较 TBW 组有 4°的优势（p=0.043）。两组之间 Mayo 评分、DASH 评分和屈伸 ROM 值差异均有统计学意义。
两种手术技术均适用于尺骨鹰嘴骨折的治疗，且均可靠。虽然 TBW 治疗费用低且操作简单，但由于钢丝刺激皮肤，其最大的缺点是需要二次手术取出内固定物的概率较高。
