Petraco D M, Koval K J, Kummer F J, Zuckerman J D
Department of Orthopaedic Surgery, Hospital for Joint Diseases Orthopaedic Institute, New York, New York 10003, USA.
Clin Orthop Relat Res. 1996 Dec(333):181-5.
Eighteen pairs of fresh frozen human upper extremities were selected and each randomized to 2 of 3 olecranon osteotomy and fixation technique groups: (1) transverse osteotomy with 0.062 Kirschner wire and tension band fixation; (2) chevron osteotomy with 6.5-mm cancellous lag screw and tension band fixation; and (3) oblique intraarticular osteotomy with 3.5-mm cortical lag screw and tension band fixation. The arms were mounted with the elbow at 90 degrees flexion and the wrist constrained; a dual linear displacement transducer across the osteotomy was used to determine angulation, translational displacement, and the total gap size. First the brachialis and then the triceps were incrementally loaded to 10 kg using a pulley and cable system to control force direction; the muscle load versus osteotomy displacement was recorded. Cycling with 10 kg was repeated 20 times with the brachialis and triceps alternately loaded and the osteotomy displacement remeasured. There were no statistically significant differences between the amounts of displacement for the 3 osteotomy and fixation techniques caused by either muscle action. The total displacement caused by the brachialis load for all techniques was appreciably greater than that of the triceps load. No significant increase in displacements occurred after 20 load cycles. These results suggest all 3 olecranon osteotomy and fixation techniques offer comparable stability, so the choice of technique should be left to the surgeon's preference.
选取18对新鲜冷冻的人体上肢，每对上肢随机分为3种鹰嘴截骨与固定技术组中的2组：（1）采用0.062英寸克氏针横行截骨及张力带固定；（2）采用6.5毫米松质骨拉力螺钉及张力带固定的人字形截骨；（3）采用3.5毫米皮质骨拉力螺钉及张力带固定的斜行关节内截骨。将手臂安装成肘部屈曲90度且手腕受限的状态；使用横跨截骨处的双线性位移传感器来确定成角、平移位移及总间隙大小。首先使用滑轮和缆索系统将肱肌然后将肱三头肌逐步加载至10千克以控制力的方向；记录肌肉负荷与截骨位移情况。使用10千克负荷进行循环，肱肌和肱三头肌交替加载，重复20次，并重新测量截骨位移。3种截骨与固定技术因任何一种肌肉作用所导致的位移量之间均无统计学显著差异。所有技术因肱肌负荷所导致的总位移明显大于肱三头肌负荷所导致的总位移。在20次负荷循环后，位移未出现显著增加。这些结果表明，所有3种鹰嘴截骨与固定技术均提供了相当的稳定性，因此技术的选择应留给外科医生根据个人偏好来决定。
