单臂外固定支架治疗儿童陈旧性孟氏骨折-儿科学(骨科)专业论文.docx

重庆医 重庆医科大学硕士研究生学位论文 万方数据 万方数据 单臂外固定支架治疗儿童陈旧性孟氏骨折 摘要 目的：探讨单臂外固定支架治疗儿童陈旧性孟氏骨折。 方法：2008 年 01 月—2011 年 12 月，对 22 例儿童陈旧性孟氏骨 折采用桡骨头切开复位，尺骨近端截骨、单臂外固定支架手术治疗， 男 14 例，女 7 例；年龄 2—14 岁，平均 7.2 岁。按 Boda 发分型：I 型 （伸直型）12 例，占 52.4%；II 型（屈曲型）4 例，占 19.0%；III 型（内 收型）5 例，占 23.8%；VI 型（特殊性）1 例，占 4.8%。术后石膏固 定 4-6 周。 结果：22 例患儿均获得随访，随访时间 2—4.8 年，平均 2.8 年， X 线片显示骨折全部愈合 ，骨折愈合时间为 10～20 周，平均 11.8 周 ， 肱桡关系恢复正常，尺骨无骨不连、骨折畸形愈合等，术后手术效果 采用 Mackay 临床功能标准进行评定：优 18 例（81.8%），良 3 例（13.6%）， 差 1 例（4.5%）优良率 95.5%，未发生医源性神经血管损伤、尺桡骨 骨性连接、肱骨小头、桡骨小头骨折等并发症。 结论：应用单臂外固定支架治疗儿童陈旧性孟氏骨折，能有效矫 正肘部畸形，可及时进行调整，且固定牢固，术后能早期进行功能锻 炼，尽早恢复肘关节功能，是一种操作简单、安全、损伤小、疗效好 的治疗方法。 1 关键词：儿童，陈旧性孟氏骨折，外固定支架，治疗 2 THE TREATMENT OF MISSED MONTEGGIAS FRACTURE IN CHILDREN WITH SINGLE-FRAME EXTERNAL FIXATOR ABSTRACT Objective：To evaluate the results of single-frame external fixator in treating the missed Monteggias fractures in children． Methods：From January 2008 to December 2011, a total of 22 children with missed Monteggias fracture were reviewed,there were 15 male and 7 female ,the average age was 7.4 years(range ,2-14years). According to the Boda classification system :12 of type I (extension type) accounted for 54.5%;4 of type II (flexion type)18.3%; 5 of type III (adduction type)22.7%, 1 of type VI ,4.5%。 all patients were operated with single-frame external fixator fixed the fracture ulnas after reduction . the plaster was kept for 4-6 weeks postoperatively . Results: all the patients were available at the final follow up with a mean of 2.8years (range,2-4.8years). good union was achieved in all cases after11.6weeks (range 10-20 weeks).21 cases of the radiohumeral joint was returned to normal , 1 case of the radius was subluxating. There was no ulna nonunion and malunion .according to the Mackay scoring system for the 3 motion function in the children, all patients were classified at 18 excellent （81.8%）, 3good（13.6%）1 poor(4.5%), There was few complication . Conclusions: single-frame external fixator is effective for the missed Monteggias fract