Monteggia骨折150例报告(附文献复习)

Report of 150 Cases of Monteggia Fractures

小儿高位Ｍｏｎｔｅｇｇｉａ骨折亦称Ｈｕｍｅ骨折。１９８６～１９９１作者采用手法复位、纸塑瓦楞夹板固定法治疗１５０例，平均临床愈合时间４５ｄ。８７例获得随访，平均随访时间４１５月。结果优良率９３８％。作者提出扩大Ｈｕｍｅ骨折的概念范围为：小儿尺骨近段或鹰嘴骨折，合并桡骨头各方向的脱位或半脱位。作者对临床资料分析认为：（１）先整复尺骨骨折，再整复桡骨头，可使变异了的近尺桡间隙得到纠正，为桡骨头的复位创造条件。（２）Ｘ线检查采用前臂中立位投照法和“划点法”，可排除前臂旋转及伤后畸形的干扰，避免漏诊和误诊。（３）前臂中立位固定、置肘关节极度屈曲位，是维持桡骨头稳定的关键。

High Monteggia fracture is also called Hume fracture.From 1986 to 1991,the author treated 150 cases of fractures with manual reduction and fixation with paper plastic corrugated splint.The clinical healing time was 45 days on average.87 cases were followed up for an average of 41 5 months.The cure rate was 93 8%.The author suggests that the conceptual range of Hume fracture be expanded to juxtaarticular ulnar fracture or olecranal fracture of children,combined subluxation and dislocation of head of radius to various directions.According to the analysis of clinical data,the author suggests the following methods:1 First reduce ulnar fracture and then the head of radius in order to correct the space between ulna and radius and create conditions for the reduction of the head of radius.2 In X ray examination erect shadow casting and“dot linking”method should be used to get rid of the interference of rotation of the mid forearm and deformation of it after fractured,and avoid missed diagnosis and misdiagnosis.3 Erect fixation of the mid forearm and extreme flexion of the elbow joint are deys of keeping the head of radius stable,and at the same time,play a preventive role in the secondary injury of the radial nerves.