新鲜BadoⅣ型孟氏骨折的治疗与远期随访

Treatment and Long Term Follow-up of Fresh Bado Type Ⅳ Monteggia Fracture

目的探究新鲜BadoⅣ型孟氏骨折的治疗方式、远期疗效。方法选取2012年1月~2015年12月在我院治疗并随访的有较完整资料的BadoⅣ型孟氏骨折21例,其中2例采用手法复位,11例采用尺桡骨克氏针固定,5例采用尺骨克氏针固定,2例采用尺骨髓内钉固定,1例采用尺骨髓内钉固定+桡骨克氏针固定。采用Mayo评分系统进行远期疗效评价。结果 21例均获得治疗后2~5年远期随访,平均随访(3.92±2.53)年。Mayo评分优16例,良4例,一般1例,优良率95.24%。结论 BadoⅣ孟氏骨折损失机制特殊,应及时治疗,治疗上以手术治疗最常见,术后尽早行肘功能锻炼,多数可获得满意远期预后。

Objective To explore the treatment and long-term effect of fresh Bado type IV Monteggia fracture.Methods From January 2012 to December 2015,21 cases of Bado typeⅣMonteggia fractures were treated and followed up in our hospital.Among them,2 cases were treated with manual reduction and 11 cases were fixed with the ulnar and radial Kirschner wire,5 cases were fixed by the ulna Kirschner pin.2 cases were fixed with ulnar intramedullary nail and 1 cases were fixed with ulnar intramedullary nailing and radial Kirschner wire fixation.The Mayo scoring system was used to evaluate the long-term effect.Results All the 21 patients were followed up from 2 to 5 years after treatment.The mean follow-up was(3.92±2.53)years.The Mayo score was excellent in 16 cases,good in 4 cases,general in 1 case,with a good rate of 95.24%.Conclusion The mechanism of Bado type IV Monteggia fracture loss is special.It should be treated in time.The most common surgical treatment is to be treated by operation.The early elbow function exercise is done as early as possible.Most of them can get satisfactory long-term prognosis.