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克氏针张力带钢丝固定与皮质骨螺钉固定治疗尺骨鹰嘴骨折的功能和影像学结果比较——一项随机对照研究

Comparison of Functional and Radiological Outcomes of Olecranon Fractures Treated with Tension Band Wiring with Kirschner Wires to Transcortical Screw Fixation-A Randomised Controlled Study.

作者信息

Sinha Siddhartha, Maharjan Rajiv, Khanal Guru P, Pokharel Bishnu, Drolia Nikhil, Gupta Sumit, Kanojia Rajesh K, Chaudhary Pashupati

机构信息

Department of Orthopaedics, Lady Hardinge Medical College, New Delhi, India.

Department of Orthopaedics, B P Koirala Institute of Health Sciences, Dharan, Nepal.

出版信息

Strategies Trauma Limb Reconstr. 2020 Sep-Dec;15(3):131-137. doi: 10.5005/jp-journals-10080-1510.

Abstract

AIM

To compare the clinical and radiological outcomes of fixation of olecranon fractures by a transcortical screw with conventional tension band wiring (TBW) using a Kirschner wire (K-wire).

MATERIALS AND METHODS

This is a non-blinded randomised controlled trial comprising two groups ( = 30 each) with Mayo type A olecranon fractures fixed with either TBW or transcortical cancellous screws (CCS). Outcomes included the Mayo elbow performance index (MEPI), time to union, range of motion (ROM), and rates of complication among these two groups.

RESULTS

Most of the patients showed excellent scoring as per MEPI in both the groups at 6 weeks (90% in TBW group and 76.7% in CCS group) and were not significant ( = 0.719). Signs of the radiological union were noted in 80% of the cases at 6 weeks and complete at 6 months. Hardware-related complications (8.3% symptomatic hardware and 6.7% implant back-out), infection, and mean ROM were similar between the two groups (elbow flexion was 142.33 ± 24.67° in TBW group and 143.1 ± 10.19° in transcortical screw group, = 0.246) at the end of the study.

CONCLUSION

There were no statistically significant differences in the clinical-radiological outcomes and complications fixing the non-comminuted olecranon fractures with either transcortical screw or TBW.

CLINICAL SIGNIFICANCE

Transcortical screw fixation is an acceptable alternative to TBW for non-comminuted olecranon fractures in terms of union and functional outcome.

HOW TO CITE THIS ARTICLE

Sinha S, Maharjan R, Khanal GP, Comparison of Functional and Radiological Outcomes of Olecranon Fractures Treated with Tension Band Wiring with Kirschner Wires to Transcortical Screw Fixation-A Randomised Controlled Study. Strategies Trauma Limb Reconstr 2020;15(3):131-137.

摘要

目的

比较经皮质螺钉与使用克氏针的传统张力带钢丝固定术(TBW)治疗尺骨鹰嘴骨折的临床和影像学结果。

材料与方法

这是一项非盲随机对照试验,包括两组(每组n = 30),分别采用TBW或经皮质松质骨螺钉(CCS)固定梅奥A型尺骨鹰嘴骨折。结果包括梅奥肘关节功能指数(MEPI)、愈合时间、活动范围(ROM)以及两组的并发症发生率。

结果

两组中大多数患者在6周时根据MEPI评分均为优秀(TBW组为90%,CCS组为76.7%),差异无统计学意义(P = 0.719)。6周时80%的病例出现影像学愈合迹象,6个月时完全愈合。两组的硬件相关并发症(8.3%有症状的硬件问题和6.7%植入物退出)、感染和平均ROM相似(研究结束时,TBW组肘关节屈曲为142.33±24.67°,经皮质螺钉组为143.1±10.19°,P = 0.246)。

结论

使用经皮质螺钉或TBW固定非粉碎性尺骨鹰嘴骨折的临床影像学结果及并发症方面无统计学显著差异。

临床意义

就愈合和功能结果而言,经皮质螺钉固定术是治疗非粉碎性尺骨鹰嘴骨折的TBW的可接受替代方法。

如何引用本文

辛哈S,马哈詹R,卡纳尔GP,《克氏针张力带钢丝固定与经皮质螺钉固定治疗尺骨鹰嘴骨折的功能和影像学结果比较——一项随机对照研究》。《创伤肢体重建策略》2020;15(3):131 - 137。

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