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用于鹰嘴骨折和V形鹰嘴截骨术的环扎锚张力带固定术

Loop Anchor Tension Band Fixation for Olecranon Fractures and Chevron Olecranon Osteotomy.

作者信息

Ho Wei, Yao Shu-Hsin, Chen Chun-Ho

机构信息

Department of Orthopaedics, Ditmanson Medical Foundation Chia-Yi Christian Hospital.

Department of Orthopedic Surgery, National Taiwan University Hospital.

出版信息

Tech Hand Up Extrem Surg. 2022 Dec 1;26(4):250-256. doi: 10.1097/BTH.0000000000000394.

DOI:10.1097/BTH.0000000000000394
PMID:35698310
Abstract

Although tension band wiring is effective for treating olecranon fractures, it is associated with a high reoperation rate because of hardware-related problems. The loop anchor tension band technique is a novel modification of the Arbeitsgemeinschaft für Osteosynthesefragen (AO)-modified tension band wiring technique. This technique is suitable for treating olecranon fractures without severe comminution and olecranon osteotomy. In the current case series, 2 intramedullary 1.25-mm Kirschner wires (K wires) were inserted as temporary fixation into the ulnar shaft from the olecranon after anatomical reduction. The proximal end of each K-wire was bent into a loop shape and advanced deep into the triceps tendon. A transverse hole was drilled distal to the fracture site, and a 1.0-mm metal wire was passed through the bone tunnel and the loops. The wire was tightened to form a figure-of-eight tension band construct. In total, 10 patients with a mean age of 49 (range: 19 to 85) years were included in this pilot series. The mean and minimum follow-up periods were 13.9 and 12 months, respectively. All fractures achieved favorable union, both radiographically and clinically. The mean QuickDASH score was 15.4 (range: 13.6 to 18.2) and the mean Mayo elbow performance score was 94 (range: 85 to 100). None of the patients experienced K-wire migration. The loop anchor tension band technique is a simple, cost effective modification of conventional tension band wiring and exhibited no implant migration in a pilot series.

摘要

尽管张力带钢丝固定术在治疗尺骨鹰嘴骨折方面有效,但由于与内固定相关的问题,其再次手术率较高。环扎锚钉张力带技术是对骨科学会(AO)改良张力带钢丝固定技术的一种新颖改进。该技术适用于治疗无严重粉碎的尺骨鹰嘴骨折及尺骨鹰嘴截骨术。在当前病例系列中,解剖复位后,将2根1.25毫米的髓内克氏针(K针)从尺骨鹰嘴插入尺骨干作为临时固定。每根K针的近端弯成环状并深入肱三头肌腱。在骨折部位远侧钻一个横向孔,一根1.0毫米的金属丝穿过骨隧道和环。收紧金属丝以形成8字形张力带结构。该初步系列共纳入10例患者,平均年龄49岁(范围:19至85岁)。平均随访期和最短随访期分别为13.9个月和12个月。所有骨折在影像学和临床上均获得良好愈合。平均QuickDASH评分为15.4(范围:13.6至18.2),平均梅奥肘关节功能评分94(范围:85至100)。所有患者均未出现K针移位。环扎锚钉张力带技术是对传统张力带钢丝固定术的一种简单、经济有效的改进,在初步系列中未出现植入物移位。

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