尺骨斜行截骨成角延长术治疗儿童陈旧性孟氏骨折14例临床分析

Ulnar oblique osteotomy for old Monteggia fracture in 14 children

目的探讨尺骨斜行截骨后成角延长联合金属截骨板内固定术治疗儿童陈旧性孟氏骨折的临床效果。方法14例陈旧性孟氏骨折患儿，采用尺骨斜行截骨成角延长术将尺骨畸形明显部位斜行截断，矫正尺骨成角及短缩畸形；并应用金属截骨板固定，将桡骨头切开复位后探查修复或重建环状韧带；术后根据Mackay标准进行疗效评定。结果术后随访12-16个月，桡骨头均无再脱位，肘关节活动度较术前明显改善；疗效优10例，良4例。结论尺骨斜行截骨成角延长术联合金属截骨板内固定术治疗儿童陈旧性孟氏骨折疗效确切，可有效恢复肘关节功能、改善前臂旋转及屈曲活动受限。

Objective To explore the effect of ulnar osteotomy ＋ angular lengthening combined with metal plate fixation on old Monteggia fracture in children. Methods Fourteen children with old Monteggia fracture were treated by ulnar angular lengthening osteotomy to cut the most obvious parts of ulna deformity and correct ulnar angulation and shortening deformity. The metal plate was adopted to fix the ulna, followed by probing and repairing or reconstruction of annular ligament after the open reduction of radial head. According to the Mackay standard, the results were evaluated. Results All patients were followed up for 12 to 16 months, and the elbow activity was obviously improved with no radial head dislocation. The results were excellent in 10 patients and good in 4. Conclusion Ulnar oblique osteotomy is effective for old Monteggia fracture. It can restore elbow function, improve forearm rotation and alleviate limited flexion.