手术治疗陈旧性孟氏骨折疗效分析

Curative effect analysis of surgical treatment in old Monteggia fracture

目的探讨手术治疗陈旧性孟氏骨折临床效果。方法选择2005年9月-2010年7月陈旧性孟氏骨折患者25例,其中男性18例,女性7例;年龄5~13岁,平均年龄7岁。应用切开复位、环状韧带修复或重建和尺骨延长截骨术进行治疗。以术中出血量、手术持续时间及术后肱桡关节位置作为观察指标。术后患者根据Mackay功能评级、有无桡骨小头再脱位、桡神经是否麻痹来进行随访。结果手术时间为（95±20）min,术中出血量为（200±41）mL（使用止血带）。桡骨小头稳定者10例行环状韧带修补,其余15例行环状韧带重建。23例获得随访,随访时间为12个月~3年6个月,平均随访时间24个月。根据Mackay等功能评级,优18例,良4例,差1例,综合优良率达95.7%。结论采用切开复位、环状韧带修复或重建和尺骨延长截骨术是治疗陈旧性孟氏骨折的有效方法之一。

Objective To investigate the curative effectiveness of surgical treatment in old Monteggia fracture.Methods A total of 25 cases with old Monteggia fracture in children and adolescents from September 2005 to July 2010 were enrolled,included 18 males and 7 females,who were 5-13 years old with a mean age 7.All of them were treated with open reduction,osteotomy of ulna and restoration or angioplasty of annular ligament.The blood loss,duration of operation and location of humeroradial joint were observed as indicators.And all the patients were evaluated based on Mackay criteria,followed-up with the case of radial head dislocation and radial nerve paralysis.Results The operation time was（95 ± 20） minutes,the amount of intra-operative bleeding was（200 ± 41） mL（with tourniquet）.Ten cases of Radial capitulum stable performed routine annular ligament repair,15 performed routine annular ligament reconstruction.Twenty-three cases were followed-up for 12 months to 3 years and 6 months（mean 24 months）.The results of treatment were evaluated as excellent in 18 cases,good in 4 cases and poor in 1 case by Mackay Functions Rating,the excellent and good rate was 95.7 %.Conclusion It is an effective method to treat the old Monteggia fracture with open reduction,osteotomy of ulna and restoration or angioplasty of annular ligament.