儿童孟氏骨折的治疗探讨

目的探讨儿童孟氏骨折的临床特点及治疗效果.方法报道58例儿童孟氏骨折.患儿平均年龄7.1岁(2岁～14岁).新鲜骨折47例,陈旧骨折11例;开放性损伤3例,闭合性损伤9例;合并桡神经损伤55例.作者对上述骨折进行临床分型,采用闭合复位加外固定治疗22例,切开复位内固定治疗37例,桡神经修复1例.结果49例经随访半年～3年(平均14个月),优良率为93.9%.结论儿童孟氏骨折与成人不同,宜将此类损伤分为五型并使用不同的治疗方案.开放性骨折、闭合性骨折复位不理想、影响功能的陈旧骨折、合并桡神经损伤者均应行手术治疗.

Treatment of Monteggia Fracture in Children

To discuss the characters and results of Monteggia fracture in children. Methods' 58 patients with Monteggia fractures were reported. The patients' age ranged from 2 to 14 year-old. 47 of them were fresh fractures and 11 were obsolete; 3 were opened injuries and 12 were closed, 9 were associated with injuries of radial nerves. A new clinical classification of Monteggia fractures was adopted in these patients. Closed reduction adding external fixation was obtained in 22. Internal fixation was given in 37. Injury of radial nerve was repaired in 1. Results: 49 patients were followed up from 0.5 year to 3 years (mean, 14 months). The rate of excellent and good results was 93.9%. Conclusions: The characters of Monteggia fractures in children are different from those in adults. Five clinical types of this fracture should be adopted and different treatments should be given according to its classification. The operation should be performed in open fractures, closed fractures in failure, obsolete fractures with non-ideal function and fractures with injuries of radial nerves.