尺骨截骨联合环状韧带重建治疗儿童陈旧性孟氏骨折的临床疗效  

Clinical observation of annular ligament reconstruction combined with ulnar osteotomy in treatment of children’s old Monteggia fracture

作　　者：韦财 廖海浪 杨文彬 曾令源 WEI Cai;LIAO Hai-lang;YANG Wen-bin;ZENG Ling-yuan(Department of Orthopaedics,Laibin People's Hospital,Laibin Guangxi 546100,China)

机构地区：[1]来宾市人民医院骨科

出　　处：《局解手术学杂志》2019年第10期820-824,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：来宾市科学研究与技术开发计划(来科转143710)

摘　　要：目的探讨尺骨截骨联合环状韧带重建治疗儿童陈旧性孟氏骨折的临床疗效。方法选择我院2010年2月至2015年2月30例陈旧性孟氏骨折患者,根据不同的手术治疗方式将其分为2组,观察组(15例)行尺骨截骨联合环状韧带重建术,对照组(15例)行尺骨截骨术。采用Mackay肘关节功能评定标准评价2组疗效,并比较2组骨折愈合时间、前臂屈伸、旋转角度、并发症的差异。结果 30例患者均随访2~6. 6年,平均随访3. 6年。2组患者骨折愈合时间比较差异无统计学意义(P> 0. 05);2组术后屈曲、伸直、旋后角度均较术前显著增加,差异具有统计学意义(P <0. 05),但组间对比差异无统计学意义(P> 0. 05)。2组Mackay优良率、总并发症发生率对比差异无统计学意义(P> 0. 05);观察组桡骨小头脱位发生率低于对照组,差异具有统计学意义(P <0. 05)。结论环状韧带重建术联合尺骨截骨治疗儿童陈旧性孟氏骨折可增加桡骨头稳定性,显著矫正肘关节畸形、改善肘关节功能。Objective To explore the clinical efficacy of annular ligament reconstruction combined with ulnar osteotomy in the treatment of children's old Monteggia fracture. Methods According to the different surgical ways,30 children with old Monteggia fracture were divided into two groups. The observation group ( 15 cases) underwent annular ligament reconstruction combined with ulnar osteotomy,and the control group ( 15 cases) underwent ulnar osteotomy. The efficacy of the two groups was evaluated by the Mackay elbow functional evaluation standard,and the differences of fracture healing time,forearm flexion and extension,rotation angle,complications were compared between the two groups. Results The results of the 30 patients who were followed up for 2. 6 to 6. 6 years ( with an average of 3. 6 years) were analyzed. There was no statistically significant difference between the two groups in fracture healing time ( P >0. 05). Postoperative flexion,extension and rotation angle were significantly increased in both of the two groups compared with those before surgery ( P <0. 05),but there was no significant difference between the two groups ( P >0. 05). There was no significant difference in the Mackay good rate and the total complication rate between the two groups ( P >0. 05). In the observation group,the incidence of dislocation of capitulum radius was lower than that of the control group,the difference was significant ( P <0. 05). Conclusion Annular ligament reconstruction combined with ulnar osteotomy for the treatment of children's old Monteggia fracture can increase the stability of the radial head,correct the elbow deformity and improve the elbow joint function significantly.

关 键 词：环状韧带重建术 尺骨截骨 儿童 陈旧性孟氏骨折 

分 类 号：R683.41[医药卫生—骨科学]