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目的 探讨儿童Monteggia Ⅳ型骨折 (Bado’分型 )的定义、损伤机制及治疗。 方法 回顾分析 1991～ 2 0 0 0年间收治的 9例儿童桡骨头脱位伴前臂双骨折或多节段骨折病例的相关资料。桡骨头均向外或前脱位 ,分别伴尺桡骨近 1/ 3骨折、中 1/ 3骨折、远 1/ 3骨折、尺桡骨远 1/ 3骨折和尺骨近 1/ 3骨折、桡骨远 1/ 3骨折和尺骨近 1/ 3骨折 ;均用手术复位 ,分别内固定桡骨、桡骨及肱桡关节、尺骨及肱桡关节、尺桡骨 ;随访 6个月以上 ,无筋膜间室综合征、感染、骨化性肌炎、神经损伤 ,无骨不连、生长障碍、骨性连接、肘内外翻 ,无上下尺桡关节不稳及再脱位或骨折 ,2例患儿残留旋转 5°～10°受限 ,屈伸约 15°受限。结果 按Morrey系统评定 ,好 7例 ,一般 2例 ,差 0例。 结论 儿童Mon teggia Ⅳ骨折 (Bado’分型 )的定义为桡骨头脱位伴前臂双骨折或多节段骨折 ;由肘过伸、前臂过度旋转受力所致 ;手术复位内固定是最佳治疗方法
Objective To investigate the definition, injury mechanism and treatment of Monteggia type Ⅳ fracture (Bado ’typing) in children. Methods Retrospective analysis of 9 cases of children with radial head dislocation between 1991 and 2000 with forearm double or multi-segment fracture cases related information. Radial head were out or anterior dislocation, respectively, with nearly 1/3 distal radius fracture, 1/3 fracture, far 1/3 fracture, distal radius and ulna 1/3 fracture and ulna nearly 1/3 fracture, 3 fractures and ulnar nearly 1/3 fracture; were operated reduction, respectively, the radius, radius and humeral joint, ulnar and brachioradialis, ulna and radius; follow-up more than 6 months, no compartment syndrome, infection , Myositis ossificans, nerve injury, nonunion, growth disorder, osseous connection, elbow valgus, upper and lower radioulnar joint instability and re-dislocation or fracture, 2 cases of children with residual rotation of 5 ° ~ 10 ° Restricted, flexion and extension of about 15 ° limited. Results According to the Morrey system, 7 were good, 2 were fair and 0 were poor. Conclusions Children with Monteggia Ⅳ fracture (Bado ’classification) are defined as radial head dislocations with or without multiple fractures of the forearm; due to over-extension of the elbow and over-rotation of the forearm, surgical reduction and internal fixation is the best treatment