Department of Orthopedics and Traumatology, Turku University Hospital and University of Turku, Turku, Finland.
Department of Orthopedics and Traumatology, Turku University Hospital and University of Turku, Turku, Finland.
J Shoulder Elbow Surg. 2021 Oct;30(10):2412-2417. doi: 10.1016/j.jse.2021.03.138. Epub 2021 Mar 24.
Olecranon fractures are common and usually treated operatively either by tension band wiring (TBW) or plate fixation (PF). The aim of this study was to assess early complications and reoperations and their predictive factors related to those operative methods.
A retrospective analysis of all patients with an operatively treated olecranon fracture between 2007 and 2017 at Turku University hospital was performed. Reoperations, postoperative complications, and potential risk factors for these were recorded.
A total of 434 patients (387 TBW and 47 PF) were identified. There was no statistically significant difference in the rate of early complications (49% vs. 62%, P = .262) or reoperations (38% vs. 53%, P = .079) between patients treated with TBW and PF. In the TBW group, the intramedullary placement of Kirschner (K)-wires predisposed patients to complications compared to transcortical placement of the K-wires according to multivariate analysis (odds ratio [OR] 1.94, P = .026). Younger age was associated with the frequency of reoperations, the odds decreasing 24% for every 10 years of age (P < .001). Further, patients with high-energy trauma mechanisms were reoperated more often compared to patients with low-energy trauma (OR 2.99, P = .002). Also, excellent postoperative reduction was associated with higher reoperation rate than good or fair reduction (OR 0.48, P = .033).
There is a high risk of early complications and reoperations associated to both TBW and PF. Transcortical positioning of K-wires may reduce the rate of complications in TBW.
尺骨鹰嘴骨折较为常见，通常通过张力带钢丝固定（TBW）或钢板固定（PF）进行手术治疗。本研究旨在评估与这两种手术方法相关的早期并发症和再次手术及其预测因素。
对 2007 年至 2017 年图尔库大学医院所有接受手术治疗的尺骨鹰嘴骨折患者进行回顾性分析。记录再次手术、术后并发症及这些并发症的潜在危险因素。
共纳入 434 例患者（387 例 TBW 和 47 例 PF）。TBW 组和 PF 组的早期并发症发生率（49% vs. 62%，P =.262）或再次手术率（38% vs. 53%，P =.079）无统计学差异。多因素分析显示，与皮质骨穿针相比，髓内克氏针（K）固定更易导致 TBW 组患者发生并发症（比值比 [OR] 1.94，P =.026）。年龄越小，再次手术的频率越高，每增加 10 岁，再次手术的几率降低 24%（P <.001）。此外，与低能创伤机制相比，高能创伤机制患者更常接受再次手术（OR 2.99，P =.002）。而且，术后复位效果良好或可接受的患者再次手术率低于复位效果优秀的患者（OR 0.48，P =.033）。
TBW 和 PF 均有发生早期并发症和再次手术的高风险。TBW 中 K 针的皮质骨穿针固定可能会降低并发症发生率。
