[Choice of internal fixation selection and clinical effect of olecranon fracture].

OBJECTIVE: To compare clinical effects of common Kirschner wire, anatomical plate and perforated Kirschner wire in treating olecranon fracture.

METHODS: From March 2014 to May 2017, clinical data of 79 patients with olecranon fracture treated with different internal fixation was retrospectively analyzed. Among them, 26 patients treated with common Kirschner wire (group A), including 19 males and 7 females aged from 23 to 51 years old with an average of (37.2±9.6) years old;11 patients were typeⅠ, and 15 patients were typeⅡ according to Mayo classification. Twenty eight patients were treated with olecroanon anatomical plate internal fixation, including 16 males and 12 females aged from 25 to 52 years old with an average of (36.6±8.9) years old;10 patientswere typeⅠ and 18 patients were typeⅡ according to Mayo classification. Twenty five patients were treated with perforated Kirschner wire, including 13 males and 12 females aged from 26 to 51 years old with an average of (38.2±9.2) years old;9 patients were typeⅠand 16 patients were typeⅡ according to Mayo classification. Operation time, intraoperatve blood loss, fracture healing time and postoperative complications among three groups were compared; VAS score at 1 week after operation was used to evaluate pain relief, Broberg-Morrey function score of elbow joint at the final follow up was applied to evaluate clinical effect.

RESULTS: Seventy nine patients were followed up from 13 to 23 months with an average of (18.3±4.5) months. Operation time, intraoperatve blood loss, fracture healing time in group A were (82.9±19.7) min, (113.5±32.3) ml, (4.2±0.6) months respectively;in group B were(101.2±24.5) min, (150.2±39.5) ml, (4.6±0.8) months respectively;in group C were (83.3±18.7) min, (119.3±34.3) ml, (4.1±0.5) months respectively. Operation time, intraoperatve blood loss, fracture healing time in group A and group C were better than that of group B( P <0.05). Five patients in group A occurred ineffective internal fixation, other groups did not occurred;9 patients in group A occurred skin irritability, 3 patients in group B and no patient occurred in group C; there were statistical differences in complications among three groups ( P <0.05). There were no differences in VAS score at 1 week after operation and Broberg-Morrey function score of elbow joint at the final follow-up among three groups ( P >0.05).

CONCLUSION: Common Kirschner wire has more complications; anatomical plate has greater surgical trauma and long fracture healing time;while perforated Kirschner wire was not only benefit for fracture union with less trauma, but also could reducing the incidence of postoperative complications, and it is the appropriate method for patients with olecranon fracture.