儿童陈旧性孟氏骨折的手术治疗.pdfVIP

2007年l2月第20卷第l2期 China J Orthop＆Trauma．Dee．2007．Vo1．20．No．12 · 845· · 经 验 交 流 · 儿童陈旧性孟氏骨折的手术治疗 姜海‘，夏松鹰 ，苗武胜‘，梁晓军‘，周梅芬‘ (1．西安市红十字会医院，陕西 西安 710054；2．哈尔滨市骨伤科医院) 【摘要】 目的：探讨和分析手术方法治疗儿童陈旧性孟氏骨折的临床效果。方法：36例儿童，男28例，女8例： 年龄4～14岁，平均9岁。按Bado分类法：I型(伸直型)19例，Ⅱ型(屈曲型)9例，Ⅲ型(内收型)5例，Ⅳ型(特殊 型)3例。根据不同病情分别行单纯切开复位治疗19例，尺骨截骨治疗l0例，尺骨延长术治疗7例。结果：36例术后 随访1～5年，平均3．5年，根据朱玉奎等评定标准，本组优24例，良6例，可3例，差3例，优良率83％。结论：恢复并 维持正确的肱桡关系是手术后取得良好效果的关键，环状韧带可以不行修补或重建。 【关键词】 骨折；尺骨；桡骨； 儿童 Surgical treatment of obsolete Monteggia fractures in children JIANG Hai ，XIA Song一：ring，MIAO Wu—sheng，LIANG Xi一 ∞jua，ZHOU Meifen． The Red Cross Hospital ofX／ aa 710054，Shaanxi，China ABSTRACT Objective：To analyze and discuss the operative method for the treatment of obsolete Monteggia fractures in children．Methods：Thirty—six patients with obsolete Monteggia fractures were reviewed，including 28 male，8 female，ranging in age from 4 to 14 years(mean，9 years)．According to the Bado classification，19 patients were type I，9 patients were type H， 5 patients were type HI，and 3 patients were type IV．According to different type，19 patients were treated with simple open re— duction，10 patients were treated with ulna osteotomy，and 7 patients were treated with ulna lengthening．Results：All the pa— tients were followed—up with the duration ranged from 1 to 5 years(averaged 3．5 years)、Based on ZHU Yu—kui criteria for eval— uation，24 patients got excellent results，6 good，3 fair and 3 bad、The excellent and good rate was 83％．Conclusion：The key point of operation is to reconstruct and maintain the normal arrangement of humerus and radius．The annular ligament need not to be repaired or reestablished． Key words Fractures； Ulna； Radius； Child Zhongguo Gushang／China J OrthopTrauma，2007，20(12)：845_846 www．zggszz．com 儿童孟氏骨折在临床较为常见，如果认识不清或处理不 复位，术中被动屈、伸肘关节，旋转前臂，见活动接近正常、无 当，很容