三种手术方法治疗尺骨鹰嘴Mayo Ⅱ型骨折的疗效比较

发布时间：2018-02-26 19:32

本文关键词： 鹰嘴骨折锁定钢板鹰嘴解剖板张力带功能锻炼　出处：《华北理工大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的通过比较克氏针张力带固定、鹰嘴解剖板、锁定钢板三种内固定方法治疗Mayo II型尺骨鹰嘴骨折的临床效果,为临床上尺骨鹰嘴骨折内固定方法的选择提供理论及实践依据,并通过本次研究,熟悉掌握临床课题研究的思路和方法。方法收集2010年1月~2013年5月华北理工大学附属骨科医院(唐山第二医院)创伤科收治的尺骨鹰嘴骨折临床病历资料,选取其中采用克氏针张力带、鹰嘴解剖板、解剖锁定钢板三种方法治疗的共计98例Mayo II型尺骨鹰嘴骨折病例,对其相关病例、手术资料、影像资料及随访记录资料进行整理进行回顾性统计分析。98例患者获得13~24个月随访,平均19.5个月,均有术后一年肘关节功能复查记录,应用改良Mayo肘关节功能评分进行功能评定。按固定方式不同分为三组,其中氏针张力带组(A组)35例;解剖板组(B组)32例;解剖锁定钢板组(C组)31例;其中克氏针张力带组男16例,女19例,年龄21~65岁,平均38.3岁;解剖板组男18例,女14例,年龄19~65岁,平均40.9岁,锁定钢板组男12例,女19例,年龄21~58岁,平均41.5岁;致伤原因:车祸伤27例,坠落伤18例,砸伤11例,打击伤11例,跌伤31例。骨折类型:Mayo IIA型49例,Mayo IIB型49例。所有病例全部属于闭合性骨折。对全部病历资料手术操作、骨折愈合、功能康复锻炼时间、术后优良率及术后并发症情况进行统计分析,比较此三种方法的综合效果。结果三组手术时间、骨折愈合时间、手术出血量情况比较差异无统计学意义(P0.05),三组无区别;三组在功能康复锻炼时间、术后肘关节功能恢复优良率、并发症发生率比较差异有统计学意义(P0.05),经组间两两比较,锁定板组在功能康复锻炼时间、优良率、并发症发生率均优于解剖板组及克氏针张力带组,解剖板组与克氏针张力带组之间无区别。结论三种内固定方法均是治疗Mayo II型尺骨鹰嘴骨折有效方法,锁定钢板在术后开始功能锻炼的时间、肘关节功能评分及术后并发症发生率方面优于克氏针张力带及解剖板组,克氏针张力带与解剖板组疗效无显著性差异。对于Mayo II型鹰嘴骨折建议应用鹰嘴锁定板固定。
[Abstract]:Objective to compare the clinical effects of tension band fixation with Kirschner's needle, anatomic plate of olecranon and locking plate for the treatment of Mayo II type ulnar olecranon fracture, and to provide theoretical and practical basis for the selection of internal fixation methods for ulnar olecranon fracture. Methods from January 2010 to 2013, the clinical records of olecranon fractures in the Department of Trauma, affiliated Orthopaedics Hospital of Hua Bei Polytechnic University (Tangshan second Hospital) were collected. A total of 98 cases of Mayo II type ulnar olecranon fracture were treated with Kirschner wire tension band, anatomic plate of olecranon and anatomic locking plate. The imaging data and follow-up records were analyzed retrospectively. 98 patients were followed up from 13 to 24 months, with an average of 19.5 months. The function of elbow joint was evaluated with modified Mayo score. According to the fixation mode, the patients were divided into three groups: group A (35 cases), group B (32 cases), group C (31 cases). There were 16 males and 19 females in the Kirschner needle tension band group, the age of 21 65 years (mean 38.3 years), 18 males and 14 females in the anatomic plate group, with an average age of 40.9 years, and 12 males and 19 females in the locking plate group, aged 21 to 58 years, with an average age of 41.5 years. The causes of injury were as follows: 27 cases of traffic accident, 18 cases of falling injury, 11 cases of smashing injury, 11 cases of hit injury, 31 cases of falling injury, 49 cases of IIA type fracture type and 49 cases of Mayo IIB type. All the cases belonged to closed fracture. The healing time of fracture, the time of functional rehabilitation exercise, the excellent and good rate after operation and the postoperative complications were statistically analyzed, and the comprehensive effects of the three methods were compared. Results the operative time and fracture healing time of the three groups were compared. There was no significant difference in the volume of blood loss between the three groups (P 0.05), and there was no significant difference among the three groups in the time of functional rehabilitation exercise, the excellent and good rate of function recovery of elbow joint after operation, and the difference in the incidence of complications (P 0.05). The locking plate group was superior to the anatomic plate group and the Kirschner needle tension band group in the duration of functional rehabilitation exercise, the excellent and good rate, and the incidence of complications. Conclusion the three internal fixation methods are effective in the treatment of Mayo type II olecranon fracture, and the time of the locking plate to start functional exercise after operation is not different between the anatomic plate group and the Kirschner wire tension band group, conclusion the three internal fixation methods are effective in the treatment of Mayo II olecranon fracture. The score of elbow joint function and the incidence of postoperative complications were better than those of Kirschner wire tension band group and anatomical plate group, but there was no significant difference between Kirschner wire tension band group and anatomical plate group.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

【参考文献】