闭合复位经皮双针固定尺骨治疗新鲜BodoⅢ型孟氏骨折的临床效果

Clinical effect of reposition and percutaneous fixation of double needle treatment on fresh BodoⅢ Monteggia fracture

目的探讨闭合复位经皮双针固定尺骨治疗新鲜BodoⅢ型孟氏骨折的疗效。方法 38例闭合性骨折患儿,均为BodoⅢ型孟氏骨折并采用闭合复位经皮双针固定尺骨。结果 38例患儿均获得随访,随访时间12~18个月,平均15个月。所有患儿无缺血性肌挛缩;在术后8周复查时,所有患儿骨折均愈合,无骨折延迟愈合及骨折不愈合,拔除克氏针;3例患儿发生穿针部位皮肤激惹,局部红肿,拔除克氏针后局部肿胀消失;22例合并桡神经损伤者,术后3~8周后神经功能恢复,未行神经探查;至随访结束时,所有患儿无桡骨头再脱位,根据Mackay病情评分标准评定疗效,其中优33例,良5例。结论闭合复位经皮双针固定尺骨治疗新鲜BodoⅢ型孟氏骨折是一种效果良好、并发症少、有利于减少住院时间及花费的方法。

Objective To study the curative effect of closed reposition and percutaneous fixation of double needle treatment on fresh Bodo Ⅲ Monteggia fracture. Methods A total of 38 cases of children with Bodo Ⅲ closed Monteggia fracture were treated with closed reposition and percutaneous fixation of double needle. Results Thirty -eight cases of children were followed up for 12 to 18 months, with an average of 15 months. All the children had no ischemic contracture. At the 8 weeks after the operation, fractures of all the children healed, and no fracture of delayed union and nonunion, Kirschner wire were pulled out. Three cases of children had skin puncture sites with shock, local redness, local swelling disappeared after removal of Kirschner wire. The neurological function of 22 children with radial nerve injury recovered after 3-8 weeks, and no nerve exploration was performed. At the end of the follow-up, there was no redislocation of radial head in all the children, the curative effect was evaluated according to the Mackay scoring criteria, of which 33 cases were excellent and 5 cases were good. Conclusion Closed reposition and percutaneous fixation of double needle treatment for fresh Bodo Ⅲ Monteggia fracture is a kind of methods with good effect, less complications, and be advantage to reduce the hospitalization time and cost. KEYWORDS： closed reposition; external fixation; Bodo Ⅲ Monteggia fracture