BACKGROUND Monteggia and equivalent lesions are relatively rare but result in severe injuries in childhood,typically affecting children between 4 and 10 years old.The diagnosis and treatment of an equivalent Monteggia...BACKGROUND Monteggia and equivalent lesions are relatively rare but result in severe injuries in childhood,typically affecting children between 4 and 10 years old.The diagnosis and treatment of an equivalent Monteggia lesion is more complicated than those of a typical Monteggia fracture.This type of lesion may be challenging and may lead to serious complications if not treated properly.Pediatric Monteggia equivalent type I lesions have been reported in a few reports,all of which the patients were all over 4 years old.CASE SUMMARY A 14-mo-old boy was referred to our clinic after falling from his bed 10 d prior.With regard to the clinical examination,an obvious swollen and angular deformity was noted on his right forearm.Plain radiographs and reconstructed computed tomography scans showed a Monteggia type I fracture and dislocation.Magnetic resonance imaging(MRI)confirmed a type I Monteggia equivalent lesion consisting of ulnar fracture and Salter-Harris type I injury in the proximal radius.The radial head was still in the joint,and only the radial metaphysis was displaced anteriorly.Open reduction and pinning of both displaced radial and ulnar fractures achieved an excellent result with full function.CONCLUSION We recommend MRI examination or arthrography during reduction,especially if the secondary ossification center has not appeared.展开更多
Purpose： To study the effects of surgical and nonoperative treatment on wrist function in patients with distal radius fracture. Methods： In total, 97 patients treated for distal radius fracture in the Department of ...Purpose： To study the effects of surgical and nonoperative treatment on wrist function in patients with distal radius fracture. Methods： In total, 97 patients treated for distal radius fracture in the Department of Orthopedic Trauma at the People＇s Hospital of Peking University from Jan. 2010 to Jun. 2016 were selected for outpatient follow-up, including manipulative reduction and dorsal splint fixation in 24 cases, bivalve cast fixation in 19 cases and open reduction and internal fixation in 54 cases. Evaluation was based on Sartiento＇s modification of the Gartland and Werley score. Efficacy was assessed with wrist pain as the focus. Results： The wrist function scores of the surgical group were better than nonoperative groups. There was no significant difference in wrist function scores between the dorsal splint group and the bivalve cast group. The ulnar wrist pain incidence had no significant difference in surgical and nonoperative groups. The displace rate in dorsal splint group was higher than other groups. Conclusion： The overall effect of surgical treatment of distal radius fracture is better than nonoperative treatment. The ulnar wrist pain incidence has no significant difference in these groups. Dorsal splint fixation is more prone to displace than bivalve cast fixation.展开更多
文摘BACKGROUND Monteggia and equivalent lesions are relatively rare but result in severe injuries in childhood,typically affecting children between 4 and 10 years old.The diagnosis and treatment of an equivalent Monteggia lesion is more complicated than those of a typical Monteggia fracture.This type of lesion may be challenging and may lead to serious complications if not treated properly.Pediatric Monteggia equivalent type I lesions have been reported in a few reports,all of which the patients were all over 4 years old.CASE SUMMARY A 14-mo-old boy was referred to our clinic after falling from his bed 10 d prior.With regard to the clinical examination,an obvious swollen and angular deformity was noted on his right forearm.Plain radiographs and reconstructed computed tomography scans showed a Monteggia type I fracture and dislocation.Magnetic resonance imaging(MRI)confirmed a type I Monteggia equivalent lesion consisting of ulnar fracture and Salter-Harris type I injury in the proximal radius.The radial head was still in the joint,and only the radial metaphysis was displaced anteriorly.Open reduction and pinning of both displaced radial and ulnar fractures achieved an excellent result with full function.CONCLUSION We recommend MRI examination or arthrography during reduction,especially if the secondary ossification center has not appeared.
文摘Purpose： To study the effects of surgical and nonoperative treatment on wrist function in patients with distal radius fracture. Methods： In total, 97 patients treated for distal radius fracture in the Department of Orthopedic Trauma at the People＇s Hospital of Peking University from Jan. 2010 to Jun. 2016 were selected for outpatient follow-up, including manipulative reduction and dorsal splint fixation in 24 cases, bivalve cast fixation in 19 cases and open reduction and internal fixation in 54 cases. Evaluation was based on Sartiento＇s modification of the Gartland and Werley score. Efficacy was assessed with wrist pain as the focus. Results： The wrist function scores of the surgical group were better than nonoperative groups. There was no significant difference in wrist function scores between the dorsal splint group and the bivalve cast group. The ulnar wrist pain incidence had no significant difference in surgical and nonoperative groups. The displace rate in dorsal splint group was higher than other groups. Conclusion： The overall effect of surgical treatment of distal radius fracture is better than nonoperative treatment. The ulnar wrist pain incidence has no significant difference in these groups. Dorsal splint fixation is more prone to displace than bivalve cast fixation.
