本文關(guān)鍵詞： 鷹嘴骨折 鎖定鋼板 鷹嘴解剖板 張力帶 功能鍛煉　出處：《華北理工大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的通過比較克氏針張力帶固定、鷹嘴解剖板、鎖定鋼板三種內(nèi)固定方法治療Mayo II型尺骨鷹嘴骨折的臨床效果,為臨床上尺骨鷹嘴骨折內(nèi)固定方法的選擇提供理論及實踐依據(jù),并通過本次研究,熟悉掌握臨床課題研究的思路和方法。方法收集2010年1月~2013年5月華北理工大學(xué)附屬骨科醫(yī)院(唐山第二醫(yī)院)創(chuàng)傷科收治的尺骨鷹嘴骨折臨床病歷資料,選取其中采用克氏針張力帶、鷹嘴解剖板、解剖鎖定鋼板三種方法治療的共計98例Mayo II型尺骨鷹嘴骨折病例,對其相關(guān)病例、手術(shù)資料、影像資料及隨訪記錄資料進行整理進行回顧性統(tǒng)計分析。98例患者獲得13~24個月隨訪,平均19.5個月,均有術(shù)后一年肘關(guān)節(jié)功能復(fù)查記錄,應(yīng)用改良Mayo肘關(guān)節(jié)功能評分進行功能評定。按固定方式不同分為三組,其中氏針張力帶組(A組)35例;解剖板組(B組)32例;解剖鎖定鋼板組(C組)31例;其中克氏針張力帶組男16例,女19例,年齡21~65歲,平均38.3歲;解剖板組男18例,女14例,年齡19~65歲,平均40.9歲,鎖定鋼板組男12例,女19例,年齡21~58歲,平均41.5歲;致傷原因:車禍傷27例,墜落傷18例,砸傷11例,打擊傷11例,跌傷31例。骨折類型:Mayo IIA型49例,Mayo IIB型49例。所有病例全部屬于閉合性骨折。對全部病歷資料手術(shù)操作、骨折愈合、功能康復(fù)鍛煉時間、術(shù)后優(yōu)良率及術(shù)后并發(fā)癥情況進行統(tǒng)計分析,比較此三種方法的綜合效果。結(jié)果三組手術(shù)時間、骨折愈合時間、手術(shù)出血量情況比較差異無統(tǒng)計學(xué)意義(P0.05),三組無區(qū)別;三組在功能康復(fù)鍛煉時間、術(shù)后肘關(guān)節(jié)功能恢復(fù)優(yōu)良率、并發(fā)癥發(fā)生率比較差異有統(tǒng)計學(xué)意義(P0.05),經(jīng)組間兩兩比較,鎖定板組在功能康復(fù)鍛煉時間、優(yōu)良率、并發(fā)癥發(fā)生率均優(yōu)于解剖板組及克氏針張力帶組,解剖板組與克氏針張力帶組之間無區(qū)別。結(jié)論三種內(nèi)固定方法均是治療Mayo II型尺骨鷹嘴骨折有效方法,鎖定鋼板在術(shù)后開始功能鍛煉的時間、肘關(guān)節(jié)功能評分及術(shù)后并發(fā)癥發(fā)生率方面優(yōu)于克氏針張力帶及解剖板組,克氏針張力帶與解剖板組療效無顯著性差異。對于Mayo II型鷹嘴骨折建議應(yīng)用鷹嘴鎖定板固定。
[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.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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本文編號：1539384