Chen Jia-Ru, Mou Zhe-Fei, Zheng Jun-Ju
Department of Orthopaedic Surgery, Wenzhou Central Hospital, Wenzhou 325000, Zhejiang, China.
Zhongguo Gu Shang. 2023 Jul 25;36(7):607-13. doi: 10.12200/j.issn.1003-0034.2023.07.003.
To compare the clinical effect of three types of Kirschner wire tension band for olecranon fracture.
The clinical data of 64 patients with olecranon fracture treated by Kirschner wire tension band fixation from March 2016 to May 2020 were retrospectively analyzed. Among them, 19 patients were treated with intramedullary K-wires fixation(group A) including 8 males and 11 females with an average of (48.2±18.3) years old, 3 patients were typeⅠ, and 16 patients were typeⅡ according to Mayo classification;20 patients were treated with transcortical K-wires fixation (group B) including 13 males and 7 females with an average of (43.5±20.4) years old, 3 patients were typeⅠand 17 patients were typeⅡ according to Mayo classification;25 patients were treated with perforated Kirschner wire(group C) including 15 males and 10 females with an average of (55.2±17.5) years old, 4 patients were typeⅠand 21 patients were typeⅡ according to Mayo classification. The operative time, intraoperative blood loss, times of Intraoperative fluoroscopy, fracture healing time and complications of 3 groups were compared. At the final follow-up, elbow function was assessed using the Mayo Elbow Function Scale.
There were differences in operative time, intraoperative fluoroscopy times, postoperative VAS and soft tissue irritation among the three groups(<0.05). The operative time, intraoperative fluoroscopy times in group A and C was better than that in group B. The postoperative VAS score, skin irritability in group C was better than that of group B. The difference was statistically significant on Mayo elbow function score at the final follow-up among three groups(<0.05), the scores of group A and C were higher than that of group B.
Compared with transcortical K-wires screw fixation, both intramedullary K-wires screw fixation and perforated Kirschner wire fixation, which can significantly reduce the occurrence of soft tissue irritation, reduce surgical complications and shorten the operation time.
比较三种克氏针张力带治疗尺骨鹰嘴骨折的临床效果。
回顾性分析2016年3月至2020年5月采用克氏针张力带固定治疗的64例尺骨鹰嘴骨折患者的临床资料。其中，采用髓内克氏针固定治疗19例（A组），男8例，女11例，平均年龄（48.2±18.3）岁，按Mayo分型，Ⅰ型3例，Ⅱ型16例；采用经皮质克氏针固定治疗20例（B组），男13例，女7例，平均年龄（43.5±20.4）岁，按Mayo分型，Ⅰ型3例，Ⅱ型17例；采用多孔克氏针治疗25例（C组），男15例，女10例，平均年龄（55.2±17.5）岁，按Mayo分型，Ⅰ型4例，Ⅱ型21例。比较3组患者的手术时间、术中出血量、术中透视次数、骨折愈合时间及并发症。末次随访时，采用Mayo肘关节功能评分评估肘关节功能。
三组患者手术时间、术中透视次数、术后VAS评分及软组织刺激情况比较，差异有统计学意义（<0.05）。A组和C组手术时间、术中透视次数优于B组。C组术后VAS评分、皮肤刺激性优于B组。三组末次随访时Mayo肘关节功能评分差异有统计学意义（<0.05），A组和C组评分高于B组。
与经皮质克氏针螺钉固定相比，髓内克氏针螺钉固定和多孔克氏针固定均能显著减少软组织刺激的发生，降低手术并发症，缩短手术时间。
