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[目的]总结分析56例儿童陈旧孟氏骨折患儿骨折的原因和治疗效果,为儿童陈旧孟氏骨折的临床诊治提供支持。[方法]选取2008年1月~2013年12月本院收治的56例儿童陈旧孟氏骨折患儿病例。分析骨折原因。给予尺骨截骨术治疗,术后随访2年。采用Macky和Mayo的标准对肘关节功能进行评价,并观察手术前、后肘关节屈伸功能和前臂旋转功能的改善情况。[结果]56例陈旧孟氏骨折患儿中,24例被误诊为尺骨或尺桡骨骨折,13例为手法复位不完全,10例被误诊为软组织损伤,5例为石膏松动发生移位,4例为塑型不良。尺骨截骨术后随访2年,骨折部位均全部愈合。术后肘关节屈伸功能和前臂旋转功能均显著改善(P<0.05)。Macky评分优良率为96.4%,Mayo评分优良率为94.6%。[结论]儿童陈旧孟氏骨折多由错诊、漏诊、处理不当引起,应对患儿进行全面、细致的检查,以避免陈旧孟氏骨折的发生。尺骨截骨术对于儿童陈旧孟氏骨折有满意的临床效果。
[Objective] To summarize and analyze the causes and treatment effects of fractures in 56 children with Monteggia sicca and to provide support for the clinical diagnosis and treatment of old Monteggia fractures in children. [Methods] From January 2008 to December 2013 in our hospital 56 cases of children with Monteggia fracture cases of children. Analysis of fracture causes. To give ulnar osteotomy treatment, followed up for 2 years. Macky and Mayo criteria were used to evaluate elbow joint function, and to observe the improvement of elbow flexion and extension and forearm rotation before and after surgery. [Results] Among 56 children with old Monteggia fracture, 24 cases were misdiagnosed as ulnar or ulna radius fractures, 13 cases were incompletely reset by hand method, 10 cases were misdiagnosed as soft tissue injury, 5 cases were gypsum loose displacement, 4 Examples of bad shape. Ulnar osteotomy was followed up for 2 years and the fracture sites were all healed. Elbow flexion and extension function and forearm rotation function were significantly improved (P <0.05). Macky score excellent rate of 96.4%, Mayo score excellent rate of 94.6%. [Conclusion] Children with old Monteggia fractures are often caused by misdiagnosis, missed diagnosis and treatment, which should be checked thoroughly and carefully in order to avoid the occurrence of old Monteggia fracture. Ulnar osteotomy for children with old Monteggia fracture have a satisfactory clinical effect.