儿童陈旧性Monteggia骨折的治疗

目的探讨儿童陈旧性Monteggia骨折的治疗方法及效果。方法深圳市儿童医院收治陈旧性Monteggia骨折患儿13例，其中男8例，女5例，受伤至就诊时间平均7个月。按Bado分型：Ⅰ型9例，Ⅱ型1例，Ⅲ型3例。采用尺骨斜行截骨、克氏针分别固定尺骨和肱桡关节，术中未修复或重建环状韧带。结果15例患儿在门诊获得7个月至5年的随访，参照朱玉奎等制定的评定标准，优良率为100％。未发生骨化性肌炎、骨间背侧神经损伤、尺桡骨骨性连接、尺骨骨不连、迟发性桡骨小头脱位等并发症。结论采用尺骨斜行截骨以矫正尺骨短缩及成角畸形，维持桡骨头的正确复位和稳定固定，是治疗儿童陈旧性Monteggia骨折的有效方法。

The treatment of old monteggia's fracture in children

Objective To discuss the clinical results and treatments of old Monteggia＇ frature in children. Methods Total of 13 patients were reviewed. There were 8 males and 5 females. According to the Bado classification system ： 9 of type Ⅰ ; 1 of type Ⅱ; 3 of type Ⅲ. All patients were operated by ulna osteotomy and open reduction of radial head. The patients were fixed with double Kirschner wire after reduction of the radiohumeral joints and fractured ulnas. Neither reparation nor reconstruction annular ligament was needed. Resuits All patients were available at the final follow Up with 0.5 - 5 years. According to the ZHU yu-kui＇ s scoring system for the motion function in children： the excellent and good rate was 100%. There were no complication such as myositis ossificans, synostosis of radius and ulna, ulna nonunion, radial head dislocation and profundus radial nerve injury. Conclusions The clinical results of old Monteggia＇ frature in children was very good. Osteotomy correction proximal ulna and reduction radial head is very important.