摘要
目的通过采用开放复位、尺或桡骨截骨和重建环状韧带治疗儿童陈旧性孟氏骨折,探讨儿童陈旧性孟氏骨折的手术治疗方式。方法回顾性分析2001年3月～2005年10月收治21例(男14,女7)陈旧性盂氏骨折患儿的临床资料。年龄6个月～13岁。左侧6例,右侧15例。其中18例施行尺骨截骨,2例桡骨干截骨,同时行桡骨头切开复位、重建环状韧带和肘关节囊紧缩缝合,1例仅作肘关节囊紧缩缝合,未做环状韧带重建。结果术后平均随访时间是3年7个月,8例丧失15°(平均)旋前功能,2例X线片显示桡骨头半脱位,但无功能障碍,1例术后出现桡神经麻痹,3个月后自行恢复;全部病例肘关节屈曲较术前平均增加30°Kim’s评分标准,14例优秀,4例良好,3例差。结论开放复位、尺或桡骨截骨和重建环状韧带是治疗儿童陈旧性孟氏骨折的一种有效安全的方法。
Objective To sum up the experiences in surgical treatment for old Monteggia fracture in children. Methods The clinical data of 21 cases （14 boys, 7 girls） aged from 2. 5 to 13 years with old Monteggia fracture admitted from March 2001 to Oct. 2005 were retrospectively analyzed. There were 6 cases on the left side and 15 on the right. Among them, 18 cases underwent ulnaris oste- otomy, two cases received radial diaphysis osteotomy. Radial head open reduction,annular ligament reconstruction, cubital articulation tight sutures and internal fixation with Kirschner pin were performed at the same time. One cases had only tight sutures of cubital articulation. Results The follow-up with an average of 3 years and 7 months showed that 8 cases had loss of pronation rrovement with mean of 15 degrees. Two patients had subluxation of caput radii on X-ray film without function disturbance. One patient had transient radial nerve palsy that recovered spontaneously 3 months later. The flexion rrovement was all improved and increased 30 degrees on average. According to Kinfs scoring system, the outcome of 14 cases was satisfactory, 4 cases good, and 3 poor. Conclusions Open reduction,osteotomy and annular ligament reconstruction is a safe and effective therapy for old Monteggia fracture in children.
出处
《中华小儿外科杂志》
CSCD
北大核心
2007年第11期587-589,共3页
Chinese Journal of Pediatric Surgery
关键词
骨折
韧带
Fractures,bone
Ligaments
