尺骨鹰嘴骨折皮质骨加压螺钉固定的实验研究及临床应用

比较尺骨鹰嘴骨折加压螺钉与常用的4种内固定的强度,为临床选择内固定方法提供实验依据。用22具新鲜尸体肘关节做成横型、斜形和粉碎形鹰嘴骨折模型。用5种内固定后置于MD—10E万能电子力学试验机上,测定骨折处的位移与压力的关系;结果:钢丝内固定强度最小,钩钢板最大。髓内加压螺钉固定欠可靠。横形骨折皮质骨加压螺钉与张力带钢丝比较,统计学上无显著差异(P〉0.05),斜形骨折皮质骨加压螺丝钉强于张力带钢丝(P〈0.01)。粉碎形骨折使用钩钢板尤佳(P〈0.01)。临床应用24例中,22例平均随访14个月。骨折全部愈合,优良率达90.91％;认为皮质骨加压螺丝钉治疗横、斜形尺骨鹰嘴骨折,创伤小,操作简便,固定确切,是一种安全可靠的方法。

Experimental and clinical study of compressed screw of cortical bone to treat fracture of olecranon

Aim: To evaluate the rigidity of compressed screw of the cortical bone (CSCB) compared with the others four common technique of internal fixation and testify about experimental data in mading a choice of the internal fixation of olecranon fracture. We first reported 24 patients of olecranon fvacture by CSCB. Methods: Twenty-two fresh,cadareric elbow joint were controlled osteotomies perrormed to simulate transverw, oblique and comminuted fracture. The movement of fracture site with a bending moment to the ulna was tested in five techniques of the internal fixation. Results: The rigidity of internal fixation of the wires was the smallest and the hook plate was the biggest. The intraedullary cancellous screw fization gave little reliable result. CBCS was suporior to tension hand wiring at oblique osteotomies (P<0. 01), but no statistically significant difference was shown between CBCS and tension hand wiring at transvers osteotomise (P>0. 05). Comminuted osteotomies were held most rigidity by hook plate (P<0. 01). CBCS has been used in 24 patients and 22 patients of olecranon fracture were followed up with an average period of 14 months affer internal fixation with CBCS. Complete bony healing was foud in all patients and 90. 91% of the patients were excellent and good. Conclusion: Because of its reriable fixation, easy to insert and less damages, CBCS is the ideal chioce of the internal fixation of the olecranon fracture at transverse and oblique fractures.