低龄儿童2年以内陈旧性孟氏骨折的手术治疗

Operation treatment to young children for old Monteggia fracture within 2 years medical history

目的：探讨低龄儿童2年以内陈旧性孟氏骨折手术治疗的疗效。方法对38例2年以内陈旧性孟氏骨折低龄患儿采取尺骨近端截骨克氏针内固定，桡骨小头切开复位、肱桡关节克氏针内固定。结果38例全部得到随访，时间2-12个月。术后2例发生桡骨小头半脱位。4例桡神经损伤患儿功能完全恢复，其余患儿肘关节无畸形，无疼痛。肘关节伸直活动范围0°-20°（6°±4°），屈曲活动120°-135°（130°±5°），旋前平均80°±5°，旋后平均85°±5°。根据Mackay标准评定：优30例（78．9%），良6例（15．8%），差2例（5．3%）。结论尺骨近端截骨克氏针内固定手术治疗低龄儿童2年以内陈旧性孟氏骨折，疗效良好。

Objective To discuss the curative effect of operation treatment to young children for old Monteggia frac-ture within 2 years medical history. Methods 38 cases who suffered from old Monteggia fracture within 2 years med-ical history were treated by proximal ulna osteotomy and internal fixation by Kirschner wire, radial head open reduc-tion, and humeroradial joint internal fixation by Kirschner wire. Results All cases were followed up for 2 -12 months. 2 cases occurred radius subluxation after operation. 4 cases with radial nerve injury had been recovered com-pletely. The others had been no suffered from elbow deformity or hurt. The range of elbow joint activity function was as follows：straitening 0°-20° （6° ± 4°）,buckling 120° -135° （130° ± 5°）, the average angle of pronation was 80° ± 5°,and the average angle of supination 85° ± 5°. According to the Mackay scores：30 cases were excellent （78. 9%）, 6 good（15. 8%）,2 poor（5. 3%）. Conclusions The proximal ulna osteotomy operation is a reference treatment to young children for old Monteggia fracture within 2 years medical history. Its effect of treatment is good.