孟氏骨折伴桡神经骨间背侧支损伤的治疗分析

Treatment of posterior interosseous branch of radial nerve injury caused by Monteggia fracture

目的探讨孟氏骨折合并桡神经骨间背侧支损伤的治疗方法。方法回顾分析2006-01—2012-12我院收治的孟氏骨折患者的临床资料。新鲜骨折手法复位治疗36例(A组);新鲜骨折切开复位钢板内固定28例(B组);陈旧性骨折尺骨畸形矫正结合神经探查21例(C组)。对比3组肘关节及桡神经功能恢复情况。结果随访病例所有骨折均正常愈合。肘功能评定优良率A组91.67%,B组92.86%,C组90.48;桡神经恢复优良率A组94.44%,B组96.43%,C组95.24%;3组上述指标比较差异均无统计学意义(P>0.05)。结论孟氏骨折合并桡神经骨间背侧支损伤保守治疗能够恢复,结合病情选择合理的治疗方式可提高疗效。

Objective To discuss the treatment effect of Monteggia fracture combined with posterior interosseous nerve in-jury.Methods Clinical data of patients with humeral supracondylar fracture combined with radial nerve injury in our hospital from Jan. 2006 to Dec.2012 were retrospectively analyzed ,and the patients were divided into 3 groups.The patients with fresh fractures were treated by manual reduction（A group ,n= 36） or open reduction（B group ,n= 28） ,without exposure of the nerve.The patients with old fracture were healed up in deformity and treated by osteotomy of the ulna with plate fixation ,the nerve was exposed and neurolysis was done（C group ,n=21）.The forearm function and interossous nerve recovery were com-pared. Results All cases were healed.The excellent rate of forearm function in A group ,B group ,C group were 91.67% , 92.86% ,90.48% ,respectively.The excellent rate of interosseous nerve function were 94.44% ,96.43% ,95.24% ,respec-tively.There was no difference among the three groups in above indexes （P＆gt; 0.05）Conclusion Most of the nerve injuries caused by Monteggia fracture could recover by conservative treatment.A Reasonable treatment option can improve the thera-peutic effect.