Bioabsorbable tension band for the treatment of ulnar styloid fracture

doi:10.3969/j.issn.2095-4344.2013.25.024

Abstract

Abstract:

BACKGROUND: Selection of the appropriate internal fixation materials is an important factor in the success of fracture treatment. Bioabsorbable materials will become the hotspot fracture research.
OBJECTIVE: To investigate the material characteristics of bioabsorbable tension band and the effect on the treatment of ulnar styloid fracture.
METHODS: Thirty-six patients with ulnar styloid fracture that treated with bioabsorbable tension band and Kirschner from November 2009 to February 2012 were selected for cases analysis, including 21 male patients and 15 female patients; the age of the patients was 21-73 years, average 35.7 years. The bone fracture healing and wrist joint function was observe after treatment, and the material types, characteristics and fixation strength were in-depth studied. The pros and cons of bioabsorbable tension band and metal tension band were compared.
RESUTLS AND CONCLUSION: All the 36 ulnar styloid fracture patients were treated with bioabsorbable tension band and followed-up for 2 months to 2.5 years, average 8.5 years. X-ray examination showed the fractures were healed. The wrist joint function was evaluated with GartIand-Werley, and the results showed 24 cases of excellent, 10 cases of good, one case of average and one case of poor, and the excellent and good rate was 94%. The results indicate that bioabsorbable tension band is favorable for the recovery of joint function, and can gradually transfer the strain during fracture healing and maintain the strength on the fracture site. The degradability of the material can help to avoid the pain of secondary surgery. From the results we can indicate that bioabsorbable tension band and Kirschner wire is the ideal method for the treatment of ulnar styloid fracture.

Key words: biomaterials, biomaterial academic discussion, bioabsorbable tension band, polyglycolide, polylactide, ulnar styloid fracture, Kirschner wire, wrist function score, ulna anatomy, clinical efficacy

CLC Number:

R318

Zhou Qiang, Lu Hua, Wang Zhan-chao, Mao Yu-lun, Yu Si-ming. Bioabsorbable tension band for the treatment of ulnar styloid fracture [J]. Chinese Journal of Tissue Engineering Research, 2013, 17(25): 4733-4738.

Figures/Tables 1

2 应用生物可吸收张力带的病例分析 2.1 一般资料选取2009年11月至2012年2月在上海交通大学医学院附属新华医院崇明分院骨科采用生物可吸收张力带结合克氏针治疗的尺骨茎突骨折患者36例，其中男21例，女15例；年龄21-73岁，平均年龄35.7岁；左侧尺骨茎突骨折17例，右侧尺骨茎突骨折19例；骨折分型：Ⅰ型8例，Ⅱ型28例；受伤原因：交通伤18例，摔伤12例，砸伤6例；合并损伤：桡骨远端骨折33例，舟状骨骨折2例，月骨周围脱位1例。文章中所使用的生物可吸收张力带来源于美国强生公司。 2.2 治疗方法臂丛或者全身麻醉，常规使用充气止血带，先行合并骨折脱位的复位与固定，再取腕尺侧纵切口，以骨折端为中心，切开皮肤、皮下组织、深筋膜，于尺侧腕伸与腕屈肌腱间隙进入，切开骨膜，显露骨折端，保护尺侧副韧带以及三角软骨附着点，复位骨折端后用2根直径1.0 mm或1.5 mm的克氏针进行固定，再在尺骨茎突近端1.5 cm处用1.5 mm克氏针垂直髓腔钻孔，将2-0生物可吸收张力带穿过骨孔，与远端克氏针尾呈8字形加压固定，处理克氏针尾，反复冲洗伤口，逐层缝合伤口。治疗后给予常规抗炎处理1-3 d，石膏托外固定2-4周，治疗后2周拆线。 2.3 治疗结果所有患者伤口均Ⅰ/甲级愈合，未出现伤口感染及皮肤坏死等不良反应，治疗后36例患者均获得随访，随访时间2个月-2.5年，平均随访8.5个月，X射线检查均提示骨折愈合，采用腕关节GartIand- Werley[17]功能评分，优24例，良10例，中1例，差1例，优良率94%。典型病例：患者，男性，32岁，车祸伤入院，左桡骨远端以及左尺骨茎突骨折，其中，桡骨远端骨折行掌侧钢板固定，尺骨茎突骨折行生物可吸收张力带并结合克氏针进行内固定。治疗后3个月患者的腕关节功能恢复良好。典型病例患者在治疗前后的X射线片，见图1，2，治疗后3个月疗效见图3。"

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