孟氏骨折脱位（儿童）愈合后畸形的早期手术矫治探讨

Treating the Deformation after Monteggia Fracture Healing with the Orthopedic Operation in Nonage

目的探讨早期手术矫形治疗儿童孟氏骨折愈合后畸形的临床效果。方法本组17例，全部采用肘后外侧切口。方法一：切断尺骨并作相应延长及植骨，使肱桡关节复位；方法二：切断桡骨，复位肱桡关节后作相应短缩。重建环状韧带，并用克氏针暂时固定肱桡关节，石膏托外固定前臂于屈肘100。中立位。结果随访13—27个月，本组17例均基本获得桡骨头复位，肘关节稳定而无明显疼痛。功能恢复情况较为良好，大致接近于肢体的正常活动范围。结论对儿童孟氏骨折后畸形早期采取积极的矫形治疗措施，使桡骨头复位，矫正尺骨畸形，恢复正常的关节组合，对患儿的正常发育是有利的。即使骨与关节已有变形，在成长期也可获得重新塑型的机会。因此积极矫形较等待观望的态度更有价值。

Objective To stody the clinic effect of treating the Deformation after Monteggia fracture healing with the orthopedic operation in nonage. Methods All expose the fracture of the ulna and the dislocation of the radial head through the Boyd incision. 17 cases of thedeformation were treated with two method, the one is cut off and extend ulna with bone graft, reduce humeroradial joint, theother is cut off and decurtate radius and reest humeroradial joint, then re-establish annular ligament and fixed humeroradial joint with Kirschner wire temporarily,forearm is external fixation with piaster slab on crooked elbow 100° neutral position. Results The follow-up period for 13 to 27 months,17 cases were all obtained the head of radius resetting fundamentally. The elbow-joint is stabilization and painless obviously and the functional rehabilitation is well fairly. Conclusion The orthopedic operation is favourable for the acromegalic normal development in nonage, that the head of radius is resetted, the ulna malformation is corrected, the normal article combination is recovered. Even though bone and joint is deformation, it can obtained occasion to renew molding in growth period. It is more valuable for active re- shaping than wait-and-see expecting for this reason.