儿童陈旧性孟氏骨折22例临床分析

Clinical analysis of the results of treatment in 22 cases with old Monteggia's fracture in children

目的:探讨儿童陈旧性陈孟氏骨折的成因和手术治疗经验。方法:总结2002年1月～2006年12月间22例儿童陈旧性陈孟氏骨折病史和手术治疗经验。结果:桡骨头脱位漏诊16例,桡骨头复位再次脱位4例,忽略并发骨间背侧神经损伤2例。根据Macky等功能评定标准:优45.45%,良45.45%,差9.1%。结论:仔细询问患儿病史及体检、正确的X片拍摄阅片和重视桡骨头脱位是预防陈旧性儿童孟氏骨折的有效方法;术中纠正尺骨短缩畸形、桡骨头正确复位、不进行环状韧带重建、术后适宜康复训练可获得良好的疗效。

Objective： To analyze and discuss the causes and operative treatments of old Monteggia＇s fracture in children. Methods： To summarize the medical history and the experiences in surgical treatment of 22 old Monteggia＇s fracture in children from January 2002 to December 2006. Results. Radial head dislocation was misdiagnosed in 16 cases, radial head radiolocation in 4 cases, cubical nerve paralysis in 2 cases, and the satisfactory results were 91%. Conclusions： The main reasons of resulting in old Monteggia＇s fracture are missed diagnosis and early incorrect treatment. The reduction of radial head is crucial, it is also important to improve curative effect that early functional exercise after operation was mandatory for good operative results.