Department of Orthopedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.
Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
J Hand Surg Asian Pac Vol. 2021 Dec;26(4):571-579. doi: 10.1142/S2424835521500545.
: The trans-olecranon approach is commonly used to treat intra-articular distal humeral fractures (DHFs). We describe an osteotomy site repair technique that is both simple and safe. : We retrospectively reviewed 30 patients with intra-articular DHFs who were treated via olecranon osteotomies repaired by tension band wiring (TBW) with ring pins. Medical records and radiographs were retrospectively assessed in terms of injuries, operative characteristics, clinical outcomes, and complications, as well as any need for hardware removal. Clinical outcomes were evaluated by deriving the range-of-motion and the Mayo elbow performance score. : Thirty patients (nine men, 21 women; mean age, 49.7 years) with Arbeitsgemeinschaft für Osteosynthesefragen (AO) type 13-B and 13-C DHFs were included; the mean follow-up time was 49.9 months (range, 12-145 months). Anatomical reduction and bony union were achieved at all osteotomy sites. The mean elbow flexion was 121.7° (range, 100-135°) and the mean elbow extension was 11.3° (range, 0-30°). The mean Mayo elbow performance score was 90 points (range, 55-100 points); outcomes were excellent in 15 patients, good in 12 patients, fair in two patients, and poor in one patient. Olecranon implant removal was performed for 10 patients (33.3%; total removal in nine and isolated olecranon implant removal in one). Four of these patients (13.3%) complained of olecranon implant discomfort. Implants were removed during other surgical procedures from the remaining six patients (20%). No implant migration/breakage or wound complications were encountered. : TBW with ring pins is a simple and safe method for olecranon osteotomy site repair.
经鹰嘴截骨入路常用于治疗关节内肱骨远端骨折（DHF）。我们描述了一种既简单又安全的截骨部位修复技术。
我们回顾性分析了 30 例经鹰嘴截骨切开复位，采用张力带钢丝环扎（TBW）治疗的关节内 DHF 患者。回顾性评估了病历和 X 线片，内容包括损伤、手术特点、临床结果和并发症，以及是否需要取出内固定物。通过测量活动范围和 Mayo 肘功能评分来评估临床结果。
30 例患者（9 例男性，21 例女性；平均年龄 49.7 岁），AO 分型为 13-B 和 13-C DHF，平均随访时间为 49.9 个月（12-145 个月）。所有截骨部位均达到解剖复位和骨愈合。平均肘关节屈曲为 121.7°（范围，100-135°），平均肘关节伸展为 11.3°（范围，0-30°）。平均 Mayo 肘功能评分为 90 分（范围，55-100 分）；15 例患者结果为优，12 例患者结果为良，2 例患者结果为可，1 例患者结果为差。10 例患者（33.3%）行鹰嘴内固定取出术（9 例完全取出，1 例单独取出鹰嘴内固定）。其中 4 例（13.3%）患者诉鹰嘴内固定物不适。其余 6 例（20%）患者在其他手术中取出内固定物。未发生内固定物迁移/断裂或伤口并发症。
TBW 联合环扎钉是一种简单、安全的鹰嘴截骨部位修复方法。
