手术治疗在小儿陈旧性孟氏骨折治疗中的应用效果分析

目的探讨手术治疗在小儿陈旧性孟氏骨折治疗中的应用效果。方法通过对2008年1月—2012年12月在该院进行手术治疗的30例小儿陈旧性孟氏骨折患者,随机进行分组,分为对照组和实验组,每组15例患者。对照组患者给予尺骨截骨克氏针固定肱桡关节术进行治疗,实验组患者给予尺骨截骨掌长肌腱重建环状韧带术进行治疗。观察比较两组患者的治疗效果、术后肘关节评分及不良反应发生率。结果实验组患者总有效率为93.34%明显高于对照组患者73.33%（P〈0.05）;术前两组患者肘关节评分差异无统计学意义（P〉0.05）,实验组患者术后6个月的肘关节评分为（96.52±4.13）分较对照组患者（81.73±3.92）分明显升高（P〈0.05）;实验组患者的不良反应发生率为6.67%明显低于对照组患者33.33%（P〈0.05）。结论针对小儿陈旧性孟氏骨折患者采用尺骨截骨掌长肌腱重建环状韧带术可以明显提高治疗效果,提高患者肘关节功能,降低不良反应发生率。尺骨截骨掌长肌腱重建环状韧带术对治疗小儿陈旧性孟氏骨折具有重要的临床意义,值得推广应用。

Analysis of the Application Effect of Surgical Treatment for the Treatment of Old Monteggia Fractures in Children

Objective To investigate the application effect of surgical treatment for the treatment of old Monteggia fractures in children. Methods 30 children with old Monteggia fractures underwent surgical treatment in our hospital from January 2008 to December 2012 were randomly divided into the control group and the experimental group with 15 children in each. Patients in the control group were treated with ulnar osteotomy and transarticular fixation of humeroradial joint by Kirschner wire, and patients in the experimental group were treated with ulnar osteotomy and annular ligament reconstruction with the palmaris longus tendon. The treatment effect, postoperative elbow function score and the incidence of adverse reactions of the two groups were observed and compared. Results The total effective rate of the experimental group was 93.34%, significantly higher than 73.33% of the control group（P〈0.05）. Before operation, the difference in the elbow function score between the two groups was not statistically significant（P〉0.05）, but 6 months after operation, the elbow function score of the experimental group was（96.52±4.13） points, obviously higher than（81.73±3.92） points of the control group（P〈0.05）; the incidence of adverse reactions of the experimental group was 6.67%,significantly lower than 33.33% of the control group（P〈0.05）. Conclusion For pediatric patients with old Monteggia fractures, ulnar osteotomy and annular ligament reconstruction with the palmaris longus tendon can significantly improve the therapeutic effect and the elbow function of the patients, reduce the incidence of adverse reactions, which is of important clinical significance for the treatment of the disease, and is worthy of promotion and application.