不同方式固定尺骨鹰嘴骨折的病例对照研究

目的 ：比较采用克氏针加张力带钢丝、空心拉力螺钉及解剖型钢板3种不同内固定方式治疗尺骨鹰嘴骨折的疗效差异。方法：回顾自2010年1月至2012年1月共82例采用不同内固定方式治疗的尺骨鹰嘴骨折患者。采用张力带固定组35例（A组）,男19例,女16例;年龄32~49岁,平均（43.6±8.7）岁;骨折按Colton分型,Ⅰ型5例,ⅡA型3例,ⅡB型19例,ⅡC型8例,ⅡD型0例。空心拉力螺钉固定组20例（B组）,男13例,女7例;年龄27~50岁,平均（41.5±9.3）岁;骨折按Colton分型,Ⅰ型4例,ⅡA型4例,ⅡB型12例,ⅡC型0例,ⅡD型0例。解剖型钢板固定组27例（C组）,男15例,女12例;年龄30~55岁,平均（38.2±6.2）岁;骨折按Colton分型,Ⅰ型0例,ⅡA型0例,ⅡB型4例,ⅡC型13例,ⅡD型10例。比较各组骨折愈合时间、肘关节功能恢复情况及并发症。采用Broberg-Morrey评分系统评价3组肘关节功能。结果：患者术后均获随访,时间8~24个月,平均15个月,C组较A、B组骨折愈合时间长。术后肘关节屈伸、旋转活动度A、B组优于C组;根据Broberg-Morrey评分系统进行疗效评价,A、B组疗效优于C组。解剖型钢板固定组2例发生创口感染,6例有明显的局部异物感,1例骨折延迟愈合,1例异位骨化。张力带固定组和空心拉力螺钉固定组无创口感染,发生内固定松动失效分别为3例和2例,出现骨折延迟愈合分别为2例,皮肤滑囊形成及针尾外露破溃分别为6例和1例。结论：3种不同内固定方式对尺骨鹰嘴骨折的固定各有优缺点,应根据具体骨折类型选用合适的内固定方式。

Case-control study on therapeutic effects of different fixation methods for the treatment of olecranon fracture

Objective：To evaluate the clinical effects by comparing three different fixation methods ：tension band,hollow lag screw and anatomical plate. Methods：From January 2010 to January 2012,82 patients with olecranon fractures who underwent surgical treatments were followed up. All the patients were divided into three groups ：tension band fixation group（group A）,hollow lag screw fixation group（group B）,anatomical plate fixation（group C）. In group A,there were 35 patients,including 19 males and 16 females,ranging in age from 32 to 49 years old,with an average of（43.6±8.7） years old,and the patients were treated with tension band fixation. According to Colton classification,there were 5 cases of typeⅠ,3 cases of typeⅡ A,19 cases of type ⅡB,and 8 cases of type ⅡC in group A. Among 20 patients in group B,there were 13 males and 7 females,ranging in age from 27 to 50 years old,with an average of（41.5±9.3） years old. The patients in group B were treated with hollow lag screw fixation. According to Colton classification,there were 4 cases of typeⅠ,4 cases of typeⅡ A,and 12 cases of type ⅡB in group B. In group C,there were 27 patients totally,including 15 males and 12 females,ranging in age from 30 to 55 years old,with an average of（38.2±6.2） years old. The patients in group C were treated with anatomical plate fixation.According to Colton classification,there were 4 cases of typeⅡ B,13 cases of typeⅡ C,and 10 cases of type ⅡD in group C.The Fracture healing time,complications and functional recovery were retrospectively observed and recorded. Results：All the patients were followed up,and the duration ranged from 8 to 24 months,with an average of 15 months. The average healing time of patients in group C was the longest among three groups. The flexion extension and rotation activities of elbow joint in group B and C were better than that in group C. According to Broberg ＆ Morrey score system,the therapeutic effects of patients in group A and B were better than that of