关节囊松解被卡环状韧带下移治疗儿童陈旧性孟氏骨折

目的 探讨关节囊松解被卡环状韧带下移治疗儿童陈旧性孟氏骨折的方法及疗效。方法 2008年3月至2010年2月，采取关节囊松解被卡环状韧带下移桡骨头复位加尺骨延长成角截骨钢板内固定方法治疗Ⅰ、Ⅲ型儿童陈旧性孟氏骨折11例，男8例，女3例；年龄3～7岁7例，年龄8～11岁4例。病程2～3个月4例，4～6个月4例，7～12个月1例，13～30个月2例。结果 术后随访6个月至2年（平均9个月），随访6～12个月7例，13～24个月4例。按照Mackay[1]功能评定标准进行疗效评价，结果全部为优。X线表现无半脱位或脱位。结论 利用关节囊松解被卡环状韧带下移方法治疗儿童陈旧性孟氏骨折具有：疗效可靠，方法简单，创伤小，重建环状韧带实为环状韧带的再复位，其生物学特性完全符合伤前环状韧带。该方法值得临床医生探讨和推广。

Downward shift of the interposed annular ligament after capsular release for the treatment of pediatric old Monteggia fracture

Objective To introduce a novel method for the treatment of pediatric old Monteggia fracture by shifting the interposed annular ligament. Methods Eleven pediatric patients with Type I and Type Ⅲ old Monteggia fractures from March 2008 to February 2010 were included in this study.All the fractures were treated by shifting the interposed annular ligament after capsular release in conjunction with ulnar fixation after osteotomy lengthening and radial head reduction. There were 8 boys and 3 girls in this series. Seven cases aged in the range of 3 to 8 years old,while 4 cases in the range of 8 to 11 years old. The time from injury to operation was 2 months to 3 months in four children,3 to 6 months in 1 child, 12 months to 30 months in 3 children. Results All the operations were performed successfully and the children were followed up for 9 months (from 6 months to 24 months). Seven cases were followed up less than one year, and 4 cases more than one year. The clinical results were all graded as excellent according to Mackay's criteria. No redislocation and subluxation appeared during followup period. Conclusions Downward shifting of the interposed annular ligament is an effective and reliable method for the treatment of pediatric old Monteggia fracture, because the reduction of the annular ligament restores the mechanical and anatomical nature of the radiohumeral joint.