[目的]探讨前后联合入路行关节切开复位、尺骨截骨术治疗儿童陈旧性孟氏骨折的方法及疗效。[方法]回顾性分析2010年11月~2015年1月收治的22例陈旧性孟氏骨折患儿资料。男15例,女7例,平均年龄7.5岁。伤后至手术时间除2例分别为3年、5年外,其余20例为1~12个月。患者X线片示桡骨头脱位,尺骨桡侧或掌侧弓形弯曲,伤后时间长者见桡骨过度生长。2例伴有桡神经深支损伤症状。所有患儿均采用经肘前Henry入路行肱桡关节切开、瘢痕彻底清除,有桡神经损伤者同时行神经探查松解;肘后沿尺骨嵴做纵切口,在尺骨鹰嘴下4~5 cm横行截骨,矫正尺骨畸形并反向成角、截骨端延长后予钢板固定。所有患儿均不行环状韧带重建。[结果]本组患儿随访12~59个月,平均15.4个月。根据Mackay功能评定标准,优19例,良2例,差1例。X线片示1例再脱位、2例半脱位,余复位稳定。术后肘关节屈伸功能较术前改善,差异具有统计学意义(P<0.05);手术前后前臂旋转功能的差别无统计学意义(P>0.05)。未出现血管神经损伤、异位骨化、尺桡骨骨性连接等并发症。2例桡神经深支损伤患儿3个月内恢复正常。[结论]前后联合入路治疗儿童陈旧性孟氏骨折具有术野显露好、术中操作简便、术后并发症少等优势。前入路允许直视下处理关节内病理改变,同时便于行桡神经探查松解,后入路有利于尺骨截骨矫形术。 [Objective] To explore the method and effect of joint incision and reduction and ulna osteotomy for the treatment of old Monteggia fracture in children. [Methods] The data of 22 old Monteggia fractures admitted from November 2010 to January 2015 were retrospectively analyzed. There were 15 males and 7 females, with an average age of 7.5 years. After injury to operation time except 2 cases were 3 years, 5 years, the remaining 20 cases of 1 to 12 months. Patients showed radial head dislocation of the X-ray, ulnar or palmar arcuate curvature, the eldest of the injured time to see the radial growth of the radius. 2 cases accompanied by deep radial nerve injury symptoms. All children were treated with Henry’s approach to the elbow by the humeral and radial joint incision, the scar was completely cleared, radial nerve injury at the same time the nerve exploration release; elbow along the ulnar ridge longitudinal incision in the olecranon under the ulnar 4 ~ 5 cm transverse osteotomy, correction of ulnar deformity and reverse angulation, osteotomy end extended to the plate fixation. All children did not have annular ligament reconstruction. [Results] This group of children were followed up for 12 to 59 months, an average of 15.4 months. According to Mackay functional assessment criteria, excellent in 19 cases, good in 2 cases and poor in 1 case. X-ray showed another case of dislocation, 2 cases of subluxation, more than I rest stable. The elbow flexion and extension function of the elbow was improved after operation, the difference was statistically significant (P <0.05). There was no significant difference in forearm rotation before and after operation (P> 0.05). No vascular nerve injury, heterotopic ossification, ulna and radius bone and bone complications. Two cases of children with deep branch of radial nerve injury returned to normal within 3 months. [Conclusion] The treatment of children with old Monteggia fractures by combined anterior and posterior approach has the advantages of good surgical field exposure, simple and convenient operation, less postoperative complications. The anterior approach allows the treatment of intra-articular pathological changes under direct vision, while facilitating radial nerve exploration loosening, posterior approach is conducive to ulnar osteotomy orthopedic.