儿童陈旧性孟氏骨折的手术治疗及随诊结果

Treatment of the Delayed Monteggia's Fracture in Children

手术治疗陈旧性孟氏骨折２６例，优良率为７３％。陈旧性孟氏骨折应尽早进行桡骨头切开复位，主张在尺骨成角部位行骨膜外不全截骨，矫正尺骨成角畸形，使桡骨头复位稳定。认为术后尺桡骨融合问题与原始畸形严重及术中软组织损伤范围大有关，强调手术一定要严格无创操作，避免损伤过多的组织。

Twenty-five cases of delayed Monteggia’s fracture were treated surgically.Different surgical procedures were adopted according to the course and clinical menifestations of the injury.The patients were followed up for 52 months in average and the satisfactory results were achieved in 73%.The authors believe that surgical treatment of old Monteggia's fracture should be done as early as possible.Because.in early stage,the annular ligment can be repaired anatomically and it would be better than a reconstruction of the annular ligment by a fascia graft.Forthurmore, the less secondary changes in the upper radioulnar joint may not prevent the radial head from reduction.In order to avoid radioulnar fusion after operation,nontraumatic surgical technique should be emphasized.A partial osteotomy with osteoclasia is done at the site of angulation of the ulna to correct the angular deformity of the ulna.And this will make the radial head reduced stable.