摘要
目的探讨国产聚-DL-乳酸可吸收螺钉治疗尺骨鹰嘴骨折的效果。方法1999年12月至2006年12月，对54例尺骨鹰嘴骨折分别采用国产聚-DL-乳酸可吸收螺钉（22例）和张力带钢丝（32例）固定，对两组的疗效进行对比。结果所有患者均一期愈合，随访7～49个月（平均24．8个月）。按照Weselev标准评定肘关节功能：螺钉组优良率为90．9％（20／22）。无肘后疼痛及局部隆起，螺钉致上尺桡关节固定1例，术后5个月时旋转功能完全恢复。1例伴尺桡骨中段骨折者于术后2周复查X线片时发现鹰嘴骨折部内固定失效，骨折块分离移位，改行张力带钢丝固定，术后12个月复查，肘关节功能为良。张力带组优良率为93．8％（30／32），无内固定失效，肘后隆起伴活动时刺痛9例（28．1％），X线片显示克氏针退针3例（9．4％），所有患者均在手术后8～15个月内行第二次手术，取出内固定物。经非参数检验（Wilcoxon检验），两组优良率差异无统计学意义（W=845．0，P=0．485）。结论国产聚-DL-乳酸可吸收螺钉完全能用于治疗尺骨鹰嘴横形、斜形及骨块较大且相对完整的粉碎性骨折，且效果满意。由于可吸收螺钉能完全降解，避免二次手术，在减少患者治疗时间和费用、更快恢复原有工作方面具有明显的优势。
Objective To evaluate the results of internal fixation for olecranon fractures with home-made poly-DL-lactic acid （PDLLA） absorbable screws. Methods Fifty-four patients diagnosed as olecranon fracture were treated with internal fixation by PDLLA absorbable screws and tension band wiring respectively. In the experimental group, 22 patients were fixed using absorbable screws. In the control group, 32 patients were fixed with tension band wiring. Results The follow-ups lasted for 7 to 49 （average, 24.8） months. All the fractures obtained solid union. The outcome was evaluated by Weseley rating system. The elbow function was good to excellent in 90. 9 % of the patients in the experimental group, without pain or posterior apophysis of the elbow. Proximal radioulnar joint stiffness due to the screw was found in 1 patient, whose function of rotation recovered 5 months later. Invalid internal fixation was found by roentgenogram 2 weeks postoperatively in another 1 case who had been complicated with fractures of middle radius and ulna, and consequently had to be changed into tension band wiring. The elbow function recovered 12 months later. In the control group, the function was good to excellent in 93.8%. Nine patients （28. 1% ） complained about posterior apophysls of the elbow and pain during motion. Roentgenogram revealed the K-wires backing out in 3 cases （9.4%）. All the patients in this group had to have the internal fixators removed 8 to 15 months postoperatively. Data were statistically analyzed with SPSS 11.5. Rank sum test was used for pairwise comparison. There was no statistical significant difference in the good to excellent rate between the 2 groups （ W = 845.0, P = 0. 485） . Conclusions Open reduction and internal fixation with home-made absorbable screws is an effective way for treatment of olecranon fractures. As the screws can be degraded completely, patients need not undergo a secondary operation, obviously reducing the treatment expenditure and time.
出处
《中华创伤骨科杂志》
CAS
CSCD
2008年第7期623-626,共4页
Chinese Journal of Orthopaedic Trauma
关键词
尺骨骨折
骨折固定术
内
可吸收螺钉
Ulna fractures
Fracture fixation, internal
Absorbable screws
