用环状韧带成形术治疗儿童陈旧孟氏骨折15例

To study 15 patients with anular ligaments formed operation on children's old Monteggia fracture

目的 :儿童陈旧孟氏骨折通常需要手术治疗。传统的环状韧带重建术虽取得了一定疗效 ,但结果仍不令人满意。从 1995年 1月～ 2 0 0 2年 3月 ,采用一种新的手术方法———环状韧带成形术治疗儿童陈旧孟氏骨折 ,取得很好的效果。方法 :将前臂伸肌腱附丽从肱骨外髁处剥下 ,充分暴露肘关节前外侧关节囊。在桡骨头复位后 ,将肱骨小头前方关节囊做瓣式转移 ,修补桡骨头前方关节囊及环状韧带缺损区。桡骨头将被稳固地维持在良好的位置上。结果 :15例病人术后随诊 3～ 15个月 ,肘关节屈伸及前臂旋转活动良好 ,无肘内外翻畸形及侧方不稳定。结论 :用环状韧带成形术治疗儿童陈旧孟氏骨折 ,解决了术后前臂旋转功能受限、尺骨畸形要充分矫正等问题 。

Objective: Children's old Monteggia fracture usually needs operation.Traditional anular ligaments have succeeded,but the result is not very satisfying.From Jan.1995 Mar.2002,a new method anular ligaments formed operation on children's old Monteggia fracture comes into being and brings a better result.Methods: Take the forearm extensor tendon insertion site off the extracondyle of humerus and have the anterior lateral aricular capsule of elbow joint shown.After the head of radius reset,transfer the capitulum of humerus' front articular capsule valvularly,repair front articular capsule of the head of radius and anular ligaments' damaged point.In this way,the head of rddius will be put at the suiatble area firmly.Results: 15 patients after operation have been examined for 3 15 months,each of their elbow joints flexion and extension and forearms' conbolution can work very well.The cubitus varus and cubitus valgus and unstable side have not been found.Conclusion: Anular ligaments formed operation on children's old Monteggia fracture,forearm conbolution function bardly and ulna teratism correction' proble solved brings a better result.