尺骨截骨矫形术治疗儿童陈旧性孟氏骨折35例

Using orthopaedic osteotomy of ulna treat old Monteggia fractures in children

目的介绍应用尺骨截骨矫形术治疗儿童陈旧性孟氏骨折的临床经验,评估其临床疗效。方法对35例儿童陈旧性孟氏骨折患儿,采用Boycl切口,显露尺骨上段,肱骨头及脱位的桡骨头,将尺骨上段楔形截断,将桡骨头复位后用克氏针固定,并矫正尺骨成角及短缩畸形,用钢板固定。术后X线摄片随访。结果35例截骨部均愈合,平均愈合时间为6个月,无畸形愈合,随访9～24个月,桡骨小头与肱骨小头关系均已恢复,肘部功能全部改善。合并桡神经损伤者均恢复神经功能,平均恢复时间为术后3个月。结论应用尺骨截骨矫形术治疗儿童陈旧性孟氏骨折,能矫正前臂及肘部畸形,恢复肘关节功能,是一种行之有效的治疗方法。

Objective To introduce the clinic experience which using orthopaedic osteotomy of ulna to treat old Monteggia fractures in children, and evaluate clinic effect of it. Methods For thirty-five old Monteggia fractures in children, using Boycl incision, exposing the superior segment of ulna, head of humerus and the dislocated head of radius, than operating wedge osteotomy in the superior segment of ulna, using Kirschner wire to fix the reposited head of humerus, at last, using plat to fix the ulna which has been corrected the angulated and breviate deformity. Follow-up radiographs were performed after operation. Results Mean follow-up is 17 months（9～24 months）, all of the osteotomic part healing in the thirty-five patients, the mean healing time is 6 months, there is none malunion, the position of capitulum radius and capitulum of humerus has been reposited, and the function of elbow has been recovered to normal. All the patient who complicating with nerve radialis injurie has been recovered, the mean recovery time is 3 months after operation. Conclusion Using orthopaedic osteotomy of ulna to treat old Monteggia fractures in children, which can correct the deformity of forearm and elbow, recover the function of elbow, so this is a effective treatment.