尺骨近端截骨矫形术治疗儿童陈旧性孟氏骨折的疗效分析

目的观察尺骨近端截骨矫形术治疗儿童陈旧性孟氏骨折的临床疗效。方法回顾性分析自2008-01—2017-12采用尺骨近端截骨矫形术治疗的41例儿童陈旧性孟氏骨折,分析不同年龄段患儿的术后疗效。将年龄<12岁的患儿分为低龄组,年龄≥12岁的患儿分为大龄组,比较2组病程、手术时间、术中出血量、术后影像学Nakamura分级、末次随访时肘关节功能Kim评分。结果 41例均获得随访,低龄组随访时间平均8(6~24)个月,大龄组随访时间平均12(6~36)个月。低龄组术后1例出现感染,未出现神经损伤症状及再手术患者;大龄组术后出现2例感染,2例神经损伤症状,1例再手术。与大龄组比较,低龄组病程更短,术后影像学Nakamura分级优,手术时间更短,术中出血量更少,末次随访时肘关节功能Kim评分更优,差异有统计学意义(P <0.05)。结论尺骨近端截骨矫形术治疗儿童陈旧性孟氏骨折可获得满意的疗效,可有效恢复肘关节屈伸及旋转功能,而且低龄患儿术后的效果优于高龄患儿。

Effect of proximal ulnar osteotomy for children with old Monteggia fracture

Objective To observe the clin ical effect of the proximal ulnar osteotomy in the treatment of children with old Monteggia fracture.Methods From January 2008 to December 2017,41 children with old Menggian fracture treated with proximal ulnar osteotomy were enrolled.The postoperative efficacy of children in different age groups was analyzed.The children less than 12 years old were in younger age groups,and the children aged 12 years and older were in older age groups.The disease course,operation time,intraoperative blood loss,postoperative imaging Nakamura classification,elbow joints,and the last follow-up Feature Kim score were compared between the two groups.Results Forty-one cases were followed up,the average follow-up time in the younger group was 8(6 to 24)months,and the average follow-up time in the older group was 12(6 to 36)months.In the younger group after surgery,one patient developed infection,there were no symptoms of nerve injury and reoperation.In the older group,two patients developed infection,two patients had nerve injury symptoms,and one patient underwent reoperation.Compared with the older group,the younger group had a shorter disease course,better postoperative imaging Nakamura classification,shorter operation time,less intraoperative blood loss,and better elbow function Kim score at the last follow-up,the difference was statistically significant(P<0.05).Conclusion Proximal ulnar osteotomy can be used to treat children with old Monteggia fracture.It can effectively restore the elbow flexion and extension and rotation function,and the postoperative effect of younger children is better than that of older children.