桡骨头闭合复位、尺骨髓内针内固定治疗儿童开放孟氏骨折

Closed reduction of radial head and intramedullary fixation with ulna for the open Monteggia fracture in children

目的探讨桡骨头闭合复位、尺骨髓内针内固定治疗儿童开放孟氏骨折的临床疗效。方法采用急诊清创、桡骨头闭合复位、尺骨髓内针(克氏针或弹性髓内针)内固定治疗31例开放孟氏骨折患儿。结果患儿均获得随访,时间6～48个月。尺骨骨折均获愈合,愈合时间4～12周。5例桡神经损伤全部恢复。无感染、关节僵硬、骨化性肌炎、桡骨头坏死等并发症发生。肘关节屈伸及前臂旋转功能均恢复正常。结论儿童开放孟氏骨折采用急诊清创、桡骨头闭合复位、尺骨髓内针内固定治疗,能取得满意的效果。

Objective To investigate the clinical efficacy of closed reduction of radial head and intramedullary fixation with ulna for the open Monteggia fracture in children. Methods The 31 children with open Monteggia fracture were treated with emergency debridement,closed reduction of radial head and ulnar fracture,internal fixation with intramedullary nail（ Kirschner wire or elastic intramedullary nail） for ulna. Results All cases were followed up for 6 ～ 48 months. All the fractures were healed,and the healing time was 4 ～ 12 weeks. 5 cases of radial nerve injury returned to normal,no infection,joint stiffness,radial head necrosis and other complications occurred. Elbow flexion and extension and forearm rotation function were restored to the normal. Conclusions The method of closed reduction of radial head and intramedullary fixation with ulna for the open Monteggia fracture in children can obtain satisfactory clinical effect.