尺骨开放延长截骨加桡骨头切开复位治疗儿童陈旧性孟氏骨折

Open wedge lengthening osteotomy of ulna for the treatment of children with chronic Monteggia fracture

目的探讨尺骨截骨延长治疗儿童陈旧性孟氏骨折的方法及疗效。方法2004年5月至2011年4月，采取桡骨头复位加尺骨延长成角截骨，钢板内固定方法治疗儿童陈旧性孟氏骨折11例，男9例，女2例，年龄4-13岁（平均7岁），手术距离骨折发生时间平均5．94-月。结果术后随访1-5年（平均22个月），按照Mackay功能评定标准进行疗效评价，结果全部为优良。X线表现无半脱位或脱位。术后肘关节屈伸旋转活动明显改善，疼痛减轻。结论利用尺骨截骨方法治疗儿童陈旧性孟氏骨折具有疗效可靠，方法简单，创伤较小，容易掌握等特点。本法是治疗儿童陈旧性孟氏骨折的良好方法，值得进一步探讨和推广。

Objective To study the methods of open wedge lengthening osteotomy of ulna for management of chronic Monteggia fracture in children. Methods Eleven pediatric patients with chronic Monteggia fractures from May 2004 to April 2011 were included in this study. All the fractures were treated by open wedge lengthening osteotomy of ulna and open reduction of radial head with capsulo- plasty. There were 9 boys and 2 girls in this series. The age ranged from 4 to 13 years old, average 7 years old. The average time from injury to operation was 5.9 months. Results All the operations were performed successfully and the children were followed up for 22 months （from 12 months to 100 months）. The clinical results were all graded as excellent or good according to Mackay＇s criteria. No redislocation or subluxation appeared during follow up period. The elbow flexion, extension and fore- arm rotation were significantly improved after operation. Ulna osteotomy is an effective and reliable method for fracture. And the pain was aIso relieved. Conclusions the treatment of pediatric chronic Monteggia