| Objective:To compare the clinical outcome of tension band wires and hollow lag screws in the treatment of olecranon fracture in children.Methods:25 children of olecranon fracture at pediatric orthopedics department of Qilu Hospital of Shandong University from June 2012 to June 2018 were collected and reviewed.Those patients were treated by open reduction and internal fixation.According to the internal fixation method,the subjects were divided into the A group(K-TBW group),13 people,and B group(hollow lag screw group),12 people.All children were treated by plaster external fixation with elbow flexion at 90° and forearm at neutral position.4 weeks later,standard X-ray plain film was reviewed at the outpatient department.If the X-ray film shows blurred fracture line and callus formation in the fracture of the olecranon,we removed the external fixation and guided the children and their parents to perform functional exercises on the forearm and elbow of the affected limb.All patients were reviewed at 4th,8th,12th,24th weeks and then every 6 months postoperatively.The clinical effects of two groups were evaluated based on operation time,bleeding during operation,length of operative incision,recovery time postoperatively,postoperative complications and joint function recovery by using Mayo elbow performance scoring standard(MEPS).Results:25 patients were received long-term follow-up after operation,from 6 months to 27 months,an average of 24 months.All fractures healed well.Healing rate was 100%.and the average healing time was 59 days.Recovery time of K-TBW group was(61.92±6.29)d,and hollow lag screw group’s recovery time was(56.58±6.30)d,and there was a significant difference between the two groups(t=2.118,P<0.05).There were no complications such as infection,osteofascial compartment syndrome,malunion.nonunion,fragment redisplacement,and so on in the two groups.In K-TBW group,there was one child of Kirschner wire loosening and another child of hardware irritation reaction,and showed no significant difference in the postoperative complications between them.The average operation time:K-TBW group was(68.46±8.99)min and hollow lag screw group was(54.58 ± 6.56)min,and there was a significant difference between the two groups(t=4.378,P<0.05);blood loss:K-TBW group was(8.46±5.55)mL and hollow lag screw group was(4.83 ± 1.03)mL,and there was a significant difference between the two groups(t=2.227,P<0.05);length of operative incision:K-TBW group was(5.92± 1.26)cm and hollow lag screw group was(4.50±1.38)cm,and there was a significant difference between the two groups(t=2.698,P<0.05).With MEPS to evaluate two groups’quality rate of function recovery,there was no significant difference in statistics with 92.31%in K-TBW group and 91.67%in hollow lag screw group(χ2=0.294,P>0.05).Conclusions:Internal fixation with tension band wires and hollow lag screws in children of olecranon fracture can achieve satisfactory results.Compared with tension band wires fixation,we recommend the use of hollow lag screws for internal fixation,because the latter has the advantages of simplicity of operator,short operative time,little hemorrhage volume,less injury,rapid postoperative recovery,less cost and so on.Therefore,we believe that hollow lag screw fixation has the advantages in the treatment of olecranon fracture in children.However,due to the small number of cases and short-term following up in our center,the effect of the two surgical methods on the epiphysis still needs further follow-up study and observation. |
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