缝线Nice结张力带结合拉力螺钉固定简单横形尺骨鹰嘴骨折疗效分析

doi:10.13418/j.issn.1001-165x.2022.4.19

中国临床解剖学杂志 ›› 2022, Vol. 40 ›› Issue (4): 476-479.doi: 10.13418/j.issn.1001-165x.2022.4.19

缝线Nice结张力带结合拉力螺钉固定简单横形尺骨鹰嘴骨折疗效分析

王天放，蔡丽，施海峰，殷渠东，吴永伟*

无锡市第九人民医院骨科，江苏无锡 214062

收稿日期:2021-06-26 出版日期:2022-07-25 发布日期:2022-07-26
通讯作者: 吴永伟，主任医师，E-mail：mayunhongyqd@163.com
作者简介:王天放（1991-），男，辽宁沈阳人，硕士研究生，住院医师，主要从事创伤骨科方面研究，E-mail：mingyin031@163.com
基金资助:
无锡市“太湖人才计划”顶尖医学团队课题（WXT METTHP-07）

The effect of suture Nice knot tension band combined with lag screw fixation for simple transverse olecranon fracture

Wang Tianfang, Cai Li, Shi Haifeng, Yin Qudong, Wu Yongwei*

Department of Orthopaedics, Wuxi 9th People's Hospital, Wuxi 214062, China

Received:2021-06-26 Online:2022-07-25 Published:2022-07-26

摘要/Abstract

摘要： 目的探讨缝线Nice结张力带结合拉力螺钉固定简单横形尺骨鹰嘴骨折效果。方法选取2017年1月~2020年2月本院23例简单横行尺骨鹰嘴骨折采用缝线Nice结张力带结合拉力螺钉固定患者，其中Mayo IIA型14例，IIIA型3例，肱骨髁间粉碎骨折行尺骨鹰嘴横形截骨手术6例。记录骨愈合、患肢功能恢复和并发症情况。结果患者获12~28个月、平均（17.5±2.7）个月随访，无螺钉断裂和退钉刺激产生明显不适症状，骨折均愈合，愈合时间平均（2.3±0.5）个月。术后3个月和1年，肘关节平均屈伸范围为（103.5±22.0）°和（127.1±34.0）°，平均旋前为（72.2±7.0）°和（80.8±7.5）°，平均旋后为（70.9±6.7）°和（78.2±8.0）°，与术前比较差异有统计学意义（P<0.05）；末次随访Mayo肘关节评分为（90.7±8.3）分，优良率91.30%，内固定取出率为26.1%，其中需要取出率为4.35%。结论缝线Nice结张力带结合拉力螺钉固定简单横形尺骨鹰嘴骨折方法简便，关节功能恢复较快、较好，并发症少，内固定取除率较低。

关键词: 尺骨鹰嘴骨折； , , 内固定； , , 螺钉； , , 张力带； , , 缝线

Abstract: Objective To investigate the effect of the suture Nice knot tension band combined with lag screw fixation for simple transverse olecranon fracture. Methods From January 2016 to December 2020, 23 cases of simple transverse olecranon fracture were fixed with suture Nice knot tension band and lag screw. There were 14 cases of Mayo type IIA and Mayo 3 cases of type IIIA , as well as 6 cases of olecranon transverse osteotomy for comminuted fracture of intercondylar humerus. Elbow flexion and extension motion were started on the second day after operation. The fracture healing, limb function recovery and complications were recorded. Results All patients were followed up for 12 to 28 months, with an average follow-up of (17.5±2.7) months. There were no screw breakage and obvious discomfort caused by screw withdrawal stimulation. All the fractures healed, the average healing time was (2.3±0.5) months. At 3 months and 1 year postoperatively, the average flexion and extension range of elbow joint were (103.5±22.0) ° and (127.1±34.0) °, respectively. The average pronation range were (72.2±7.0) ° and (80.8±7.5) °, respectively. The average supination range were (70.9±6.7) °and (78.2±8.0) °,There were statistical difference between before operation and 3 months and 1 year after operation (P<0.05). At the last follow-up, the Mayo elbow performance score averaged was (87.7±8.3), the excellent and good rate was 91.3%, the removal rate of internal fixation was 26.1%, of which, the required removal rate of internal fixation was 4.35%. Conclusions Suture Nice knot tension band and lag screw fixation for simple transverse olecranon fracture has the advantages of simple performance, rapid and satisfactory functional recovery of elbow joint, lest complications and lower removal rate of internal fixation.

Key words: Olecranon fracture; , , Internal fixation; , , Screw; , , Tension band; , , Suture

中图分类号:

R683.41

王天放, 蔡丽, 施海峰, 殷渠东, 吴永伟. 缝线Nice结张力带结合拉力螺钉固定简单横形尺骨鹰嘴骨折疗效分析[J]. 中国临床解剖学杂志, 2022, 40(4): 476-479.

Wang Tianfang, Cai Li, Shi Haifeng, Yin Qudong, Wu Yongwei. The effect of suture Nice knot tension band combined with lag screw fixation for simple transverse olecranon fracture[J]. Chinese Journal of Clinical Anatomy, 2022, 40(4): 476-479.

参考文献

[1] Romero JM, Miran A, Jensen CH. Complications and re-operation rate after tension-band wiring of olecranon fractures[J]. J Orthop Sci, 2000, 5(4): 318-320. DOI: 10.1007/s007760070036.
[2] Koziarz A, Woolnough T, Oitment C, et al. Surgical management for olecranon fractures in adults: a systematic review and meta-analysis[J]. Orthopedics, 2019, 42(2): 75-82. DOI: 10.3928/01477447-20190221-03.
[3] 冯伟, 王强, 宋宝健, 等. 克氏针可吸收缝线张力带固定治疗儿童尺骨鹰嘴骨折[J]. 临床小儿外科杂志, 2018, 17(5): 367-371. DOI: 10.3969/j.issn.1671-6353.2018.05.012.
[4] 吴飞华, 徐执扬, 陈蕾, 等. 改良空心钉联合张力带内固定在肱骨髁间骨折尺骨鹰嘴截骨入路手术中的应用[J]. 中国骨与关节损伤杂志, 2020, 35(7): 755-756. DOI: 10.7531/j.issn.1672-9935.2020.07.030.
[5] Duckworth AD, Clement ND, White TO, et al. Plate versus tension-band wire fixation for olecranon fractures[J]. J Bone Joint Surg, 2017, 99(15): 1261-1273. DOI: 10.2106/JBJS.16.00773.
[6] Nimura A, Nakagawa T, Wakabayashi Y, et al. Repair of olecranon fractures using fiberwire without metallic implants: report of two cases[J]. J Orthop Surg Res, 2010, 5(1): 73-76. DOI: 10.1186/1749-799X-5-73.
[7] Wright PB, Kosmopoulos V, Coté RE, et al. FiberWire is superior in strength to stainless steel wire for tension band fixation of transverse patellar fractures[J]. Injury, 2009, 40(11): 1200-1203. DOI: 10.1016/j.injury.2009.04.011.
[8] 张世明, 李海丰, 黄轶刚. 骨折分类与功能评定[M]. 北京: 人民军医出版社, 2008: 297-301.
[9] 刘小坡, 刘德群, 刘会仁, 等. 经尺骨鹰嘴入路关节外斜行截骨对血供影响解剖学观察[J]. 中国临床解剖学杂志, 2008, 26(4): 363-365. DOI: 10.3969/j.issn.1001-165X.2008.04.005.
[10]王铁男, 秦松, 苏云, 等. 尺骨鹰嘴截骨入路治疗C型肱骨髁间骨折的疗效分析[J]. 中国临床解剖学杂志, 2020, 38(2): 221-224. DOI: 10.13418/j.issn.1001-165x.2020-02-024.
[11]吴永伟, 康永强, 芮永军, 等. Nice结辅助髓内钉与传统切口钢板治疗成人锁骨中段骨折的疗效对比[J].中华手外科杂志, 2020, 36(6): 435-439. DOI: 10.3760/cma.j.cn311653-20200218-00055.
[12]张才东, 吴刚, 罗晓中, 等. 锁定加压钢板联合Nice结治疗股骨中下段长斜行骨折[J]. 临床骨科杂志, 2019, 22(3): 355-357. DOI: 10.3969/j.issn.1008-0287.2019.03.039.
[13]Xu S, Lin HA, Wong MK. Repair of comminuted (Mayo type IIB) olecranon fracture using Ethi-bond 5 sutures without metallic implants: a novel technique[J]. J Orthop, 2019, 16(4): 329-333. DOI: 10.1016/j.jor.2019.02.002.
[14]Carofino BC, Stephen SA, Kabadi M, et al. Olecranon fractures repaired with FiberWire or metal wire tension banding: a biomechanical comparison[J]. Arthroscopy, 2007, 23(9): 964-970. DOI: 10.1016/j.arthro.2007.03.008.
[15]Kim TH, Lee DH, Han KJ, et al. Early range of motion exercise in pediatric patients with olecranon fractures treated with tension band suture with double loops and double knots[J]. J Shoulder Elbow Surg, 2017, 26(7): e227-e231. DOI: 10.1016/j.jse.2017.03.004.

缝线Nice结张力带结合拉力螺钉固定简单横形尺骨鹰嘴骨折疗效分析

The effect of suture Nice knot tension band combined with lag screw fixation for simple transverse olecranon fracture

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