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目的 对小儿孟氏骨折脱位及陈旧性孟氏骨折的传统治疗方法、创伤病理解剖、治疗结果及发生漏诊、误诊、误治的病例进行研究。以找到解决问题的方法 ,提高疗效。方法 对 170例孟氏骨折脱位患儿的致病原因、治疗方法、术中所见、手术方式以及治疗效果等进行研究、分析。结果 83例中 ,优 5 9例 ,良 15例 ,一般 9例 ,差 5例。结论 ①孟氏骨折脱位的定义应为 :尺骨干骨折合并桡 肱及桡 尺脱位 ,合并 /或不合并桡骨上 1/ 3骨折、桡骨颈骨折、桡骨头骨折脱位 ;②尺骨鹰嘴骨折合并肘关节脱位不应诊断为孟氏骨折 ;③提出“超伸直型”孟氏骨折的概念 ;④尺骨骨折的稳妥治疗及坚强内固定是治疗孟氏骨折的关键 ;⑤桡骨颈骨折既要对位好 ,更要对线好 ,以免以后发生旋转障碍 ;⑥急诊患儿可行环状韧带修补术及关节囊紧缩术 ,晚期患儿应行关节囊紧缩术 ,不主张行环状韧带重建术
Objective To study the traditional treatment of Monteggia fracture and dislocation in children and the old Monteggia fracture, the anatomy of the traumatic pathology, the results of the treatment and the cases of missed diagnosis, misdiagnosis and misdiagnosis. To find ways to solve the problem, improve efficacy. Methods 170 cases of Monte’s fracture and dislocation in children cause, treatment, intraoperative findings, surgical methods and treatment effects were studied and analyzed. Results Among the 83 cases, 59 were excellent, 15 were good, 9 were fair and 5 were poor. Conclusion ① Monteggia fracture and dislocation should be defined as: ulnar fracture combined with radiocarpal and radioulnar dislocation, with or without radial on the 1/3 fracture, radial neck fracture, radial head fracture and dislocation; ② olecranon fracture combined elbow Joint dislocation should not be diagnosed as Monteggia fracture; ③ put forward the concept of “super-straight” type Monteggia fracture; ④ ulnar fracture stabilization and rigid internal fixation is the treatment of Monteggia fracture; ⑤ radial neck fracture both Good, but also to the line is good, so as to avoid rotation disorders in the future; ⑥ emergency pediatric annular ligament repair and tightening of articular cartilage, pediatric patients should be undergone capsule compression surgery, does not advocate the line ligament reconstruction