儿童陈旧性孟氏骨折的手术治疗

Surgical treatment of obsolete Monteggia fractures in children

目的：探讨和分析手术方法治疗儿童陈旧性孟氏骨折的临床效果。方法：36例儿童,男28例,女8例;年龄4~14岁,平均9岁。按Bado分类法：Ⅰ型（伸直型）19例,Ⅱ型（屈曲型）9例,Ⅲ型（内收型）5例,Ⅳ型（特殊型）3例。根据不同病情分别行单纯切开复位治疗19例,尺骨截骨治疗10例,尺骨延长术治疗7例。结果：36例术后随访1~5年,平均3.5年,根据朱玉奎等评定标准,本组优24例,良6例,可3例,差3例,优良率83%。结论：恢复并维持正确的肱桡关系是手术后取得良好效果的关键,环状韧带可以不行修补或重建。

Objective：To analyze and discuss the operative method for the treatment of obsolete Monteggia fractures in children.Methods：Thirty-six patients with obsolete Monteggia fractures were reviewed,including 28 male,8 female,ranging in age from 4 to 14 years（mean,9 years）.According to the Bado classification,19 patients were type Ⅰ,9 patients were type Ⅱ,5 patients were type Ⅲ,and 3 patients were type Ⅳ.According to different type,19 patients were treated with simple open reduction,10 patients were treated with ulna osteotomy,and 7 patients were treated with ulna lengthening.Results： All the patients were followed-up with the duration ranged from 1 to 5 years（averaged 3.5 years）.Based on ZHU Yu-kui criteria for evaluation,24 patients got excellent results,6 good,3 fair and 3 bad.The excellent and good rate was 83%.Conclusion：The key point of operation is to reconstruct and maintain the normal arrangement of humerus and radius.The annular ligament need not to be repaired or reestablished.