- 期刊
Severely Comminuted Olecranon Fractures Involving Proximal Ulnar Shaft Treated by Ao One-Third Tubular Plate Combining with Tension Band Wiring
併用AO管型骨板和張力型帶狀鋼絲治療近端尺骨合併鷹喙部嚴重粉碎骨折
並列摘要
Open reduction with internal fixation for displaced olecranon fracture is one of the widely accepted treatment options. However, for some severely com-minuted olecranon fractures with multiple fragments or involving the shafts, it is difficult to secure the fixation by either tension band wiring or one-third tubular plate alone. Hence we combined these two fixation devices to treat severely comminuted, displaced olecranon fractures. This retrospective study included 16 patients with severely comminuted, displaced olecranon fractures who were treated surgically from July 1994 to June 1997.They were twelve male and four female patients. Their men age was 48 years old (range: 25 to 74 years). The procedure we used was to fix the major fragments with k-wires to re-align the axis. Then, a one-third tubular plate was applied on to secure the fixation. Finally, the figure-8 tension band wiring was set o with the previous K-wires. The patients were followed clinically and radiologically. The average time to solid union was 12.7 weeks. Twelve patients (75%) restored full range of motion without any pain on motion. Four patients could not perform full exten-sion of injured elbows in spite of no interference in daily lives. The average degree of extension lag was 3 degree. Among these four patients, two patients who suffered from joint pain after lifting heavy objects were found to have articular step-off greater than 2mm radiologically. Anatomic reduction. secure fixation, and early motion are essential to restore better range of motion and tri-ceps function. For those patients with severely comminuted, displaced olecranon fractures, one-third tubular plate combining with tension band wiring is a ratio-nal method to meet these requirements.