治疗肩胛骨骨折的双弯曲张力带钢丝：一种新技术

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2024-05-01 DOI:10.1016/j.jhsg.2023.12.007

Sora Koiwa MD , Takeshi Koba MD , Toshiharu Tsunoda MD , Koji Nakajima MD , Yoshiyasu Kokubo MD , Nobuhiro Hara MD

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引用次数: 0

摘要

目的本回顾性研究旨在比较传统张力带钢丝（TBW）、TBW穿刺技术和双弯曲技术的临床疗效和并发症。方法纳入2018年1月至2021年12月期间接受移位性骨折手术的40例患者（男性17例，女性23例；平均年龄：64.0±19.0岁），根据手术方法分为三组（A组，传统TBW；B组，带穿透技术的TBW；C组，双弯曲技术）。13 例患者被分配到 A 组，17 例被分配到 B 组，10 例被分配到 C 组，其中包括 2 例 Mayo IB 型骨折、30 例 Mayo IIA 型骨折和 8 例 Mayo IIB 型骨折。回顾性评估了术后效果（肘关节伸展和屈曲弧度）和并发症，如 Kirschner 线（K 线）脱落。A 组、B 组和 C 组的平均肘关节伸展弧度值分别为 6.2°、10.9° 和 0°，C 组明显优于 B 组（P = .001）。A 组的 K 线后退率为 84.6%（11/13），B 组为 41.2%（7/17），C 组为 0%（0/10）；C 组的后退率明显低于 A 组（P = .001）。结论双弯曲技术可能是防止 K 线后退和术后并发症（如活动范围受限）的最佳方法，适用于治疗可通过 TBW 治疗的肩胛骨骨折。

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Double-Bending Tension Band Wire for Olecranon Fractures: A Novel Technique

Purpose

This retrospective study aimed to compare the clinical outcomes and complications of conventional tension band wire (TBW), TBW with penetrating technique, and double-bending technique.

Methods

A total of 40 patients (17 men and 23 women; mean age: 64.0 ± 19.0 years) who underwent surgery for displaced olecranon fractures between January 2018 and December 2021 were included and divided into three groups based on the surgical method used (group A, conventional TBW; group B, TBW with penetrating technique; and group C, double-bending technique). Thirteen patients were assigned to group A, 17 to group B, and 10 to group C, including 2 Mayo type IB, 30 Mayo type IIA, and 8 Mayo type IIB fractures. Postoperative outcomes (elbow extension and flexion arc) and complications, such as backing out of the Kirschner wire (K-wire), were retrospectively evaluated.

Results

No significant difference was found in the general characteristics of the patients and fracture type among the three groups. The mean elbow extension arc values were 6.2°, 10.9°, and 0° in groups A, B, and C, respectively; it was significantly better in group C than in group B (P = .001). The rates of backing out of the K-wire were 84.6% (11/13) in group A, 41.2% (7/17) in group B, and 0% (0/10) in group C; the rate was significantly lower in group C than in group A (P < .001).

Conclusions

The double-bending technique may be the best procedure for preventing the backing out of the K-wire and postoperative complications, such as range of motion restriction, for treating olecranon fractures that are treatable by TBW.