单臂外固定支架治疗儿童陈旧性孟氏骨折
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Single-frame external fixator in the treatment of obsolete Monteggia’s fracture
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    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1月至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15例,女7例;年龄2~14岁,平均7.4岁。按Boda分型:Ⅰ型(伸直型)12例,占54.5%;Ⅱ型(屈曲型)4例,占18.3%;Ⅲ型(内收型)5例,占22.7%;Ⅵ型(特殊性)1例,占4.5%。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线片显示截骨端全部愈合,截骨端愈合时间为10~20周,平均11.6周,21例肱桡关系恢复正常,1例出现桡骨头半脱位、术后尺骨无骨不连、截骨端畸形愈合等,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(4.6%),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。

    Abstract:

    Objective:To evaluate the results of single-frame external fixator in treating obsolete Monteggia’s fractures in children.Methods:From January 2008 to December 2011,a total of 22 children with obsolete Monteggia’s fracture were reviewed including 14 males and 7 females with an average age of 7.4-year-old(ranged from 2-year-old to 14-year-old). According to the Boda classification system:there were 12 cases of type Ⅰ(extension type,54.5%),4 cases of type Ⅱ(flexion type,18.3%),5 cases of type Ⅲ(adduction type,22.7%),1 case of type Ⅵ(4.5%). All patients were operated with single-frame external fixator after the reduction. The plaster was kept for 4-6 weeks postoperatively. Results:All patients were available at the final follow up with a mean of 2.8 years(ranged from 2 years to 4.8years). Good union was achieved in all cases after 11.6 weeks(ranged from 10 weeks to 20 weeks). The radio-humeral joints of 21 cases were returned to normal and subluxating of the radius was observed in one case. There was no ulna nonunion and malunion after the operation. According to the Mackay scoring system,the motion function of 18 cases(81.8%)was excellent,3 cases(13.6%) was good,1 case(4.6%) was poor,with the excellent and good rate of 95.5%. No case of atrogenic vascular injury,os-seous connection of ulna and radius,capitellum and radial head fracture was observed. Conclusion:Single-frame external fixation is effective in the treatment of obsolete Monteggia’s fractures in children. It can rectify the elbow malformation,adjust the operation and restore elbow function. Single-frame external fixation is simple,safe,minimally invasive and has good theraputic effects.

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李海冰,李 明.单臂外固定支架治疗儿童陈旧性孟氏骨折[J].重庆医科大学学报,2015,(2):230-233

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  • 在线发布日期: 2015-11-09
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