经双皮质克氏针张力带治疗尺骨鹰嘴骨折术后前臂旋后功能障碍

目的分析双皮质克氏针张力带法治疗尺骨鹰嘴骨折导致前臂旋后功能障碍的原因。方法2000年7月至今采用该方法治疗的尺骨鹰嘴骨折病人43例。通过对术中穿入克氏针时前臂的旋转位置、克氏针的穿入方式、克氏针穿出尺骨前方皮质的长度与前臂旋后范围的相关性加以分析,以确定该方法导致前臂旋后障碍的可能原因,并提出解决办法。结果该组病人前臂旋后功能的恢复明显较旋前功能恢复差,前臂处于旋前位和交叉穿针是导致该现象的主要原因。结论经双皮质克氏针张力带治疗尺骨鹰嘴骨折时,前臂旋后功能障碍的发生率较高。严格遵循手术操作规范可降低该并发症的发生率。

Impaired Forearm Supination after Treatment of Ulnar Olecranon Fracture by Transcortical Tension - band - Wiring Technique

Objective To analyze the reasons of impairment of forearm supination after treatment of olecranon fractures with transcortical tension-band-wiring fixation. Methods Forty-three patients with olecranon fracture were treated with this method since July 2000. The position of rotation of the forearm when the wire was passing, the way of wires passing through ulna and the length of the wire passing through the anterior cortex of the ulna were recorded, and their correlations with the range of the angle of supination were analyzed to find the possible reasons of the impairment of the forearm supination and propose the solution. Results The recovery of the forearm supination was worse than that of the pronation of forearm in the patients of this group. The pronation position of the forearm during k - wire passing through the anterior cortex and the crossed K - wiring in the ulnar resulted in the impairment of the forearm supination. Conclusion The rate of the impaired forearm supination in olecranon fractures treated by transcortical tension - band - wiring technique is high. The recommended key steps must be followed to avoid the complications.