Atkin D M, Bohay D R, Slabaugh P, Smith B W
Department of Orthopedic Surgery, University of California, School of Medicine, San Francisco, USA.
Orthopedics. 1995 Jun;18(6):543-7. doi: 10.3928/0147-7447-19950601-06.
The treatment of isolated ulnar shaft fractures is controversial. Previous studies comparing treatment options have been largely retrospective and nonrandomized. In this study, consecutive patients were randomized into treatment groups of long arm plaster immobilization, short arm plaster immobilization, or Ace Wrap bandage, based on the order of hospital admission. Thirty-one patients were followed until radiographic or clinical union, with no significant difference in time to union between groups. Age, sex, fracture pattern, and displacement did not significantly influence time to union or final angulation. Two patients in both the long arm cast group and the short arm cast group lost significant motion at final follow up. Seventy percent of patients in the Ace Wrap group failed treatment secondary to pain and were converted to plaster immobilization. Furthermore, patients in this group demonstrated significantly greater angulation than those treated in a long arm cast. Our results demonstrate that above-elbow plaster immobilization offers no advantage over below-elbow immobilization. We recommend short arm casting for a period of 8 weeks.
孤立性尺骨干骨折的治疗存在争议。以往比较治疗方案的研究大多是回顾性的且未随机分组。在本研究中，连续的患者根据入院顺序被随机分为长臂石膏固定组、短臂石膏固定组或弹力绷带包扎组。31例患者被随访至影像学或临床愈合，各组之间愈合时间无显著差异。年龄、性别、骨折类型和移位对愈合时间或最终成角均无显著影响。长臂石膏固定组和短臂石膏固定组各有2例患者在最终随访时出现明显的活动受限。弹力绷带包扎组70%的患者因疼痛治疗失败而改为石膏固定。此外，该组患者的成角明显大于长臂石膏固定治疗的患者。我们的结果表明，肘上石膏固定并不比肘下固定有优势。我们建议短臂石膏固定8周。
