肱桡关节固定在儿童陈旧性孟氏骨折手术治疗中的作用  

Effect of fixation of humeroradial joint in the surgical treatment of missed monteggia fractures in children

作　　者：胡子文 管之也 单晶 李阳[1] 孙军[1] HU Zi-wen;GUAN Zhi-ye;SHAN Jing(The Children's Hospital of Anhui Medical University,Hefei 230051,Anhui)

机构地区：[1]安徽医科大学附属省儿童医院骨科,安徽合肥230051

出　　处：《安徽医专学报》2022年第3期24-26,共3页Journal of Anhui Medical College

基　　金：安徽医科大学校科学研究基金资助项目(编号:2020xkj254);安徽省儿童医院2019年中青年优秀科技人才培养项目(编号:19rtyy001)。

摘　　要：目的:探讨肱桡关节固定在手术治疗儿童陈旧性孟氏骨折中的作用。方法:回顾性研究在某医院治疗的68例陈旧性孟氏骨折患者治疗情况,根据手术方式分为观察组和对照组,对照组采取尺骨近端截骨钢板内固定+肱桡关节切开复位术,观察组在同样手术方法上另行肱桡关节固定,比较两组术后肘关节Mackay评分,术后影像学Nakamura分级,术后并发症。结果:观察组30例患者,平均末次随访时间(3.11±0.93)年;对照组38例患者,平均末次随访时间(3.70±1.02)年。两组患者搁置时间差异存在统计学意义(P<0.05),其余术前资料差异无统计学意义;术后肘关节Mackay评分、影像学评级无统计学差异(P>0.05)。结论:对于儿童陈旧性孟氏骨折的手术治疗,是否采用肱桡关节固定的总体预后差别不大,但对于搁置时间较久的陈旧性孟氏骨折患者,辅以固定桡骨小头更有利于肱桡关节稳定性,疗效更佳。Objective:To explore the effect of fixation of humeroradial joint in the surgical treatment of Missed Monteggia fractures in children.Methods:68 patients with Missed Monteggia fracture treated in hospital were selected.They were divided into observation group and control group according to the operation method.The control group was treated with proximal ulnar osteotomy plate internal fixation+open reduction of humeroradial joint,and the observation group was treated with percutaneous K-wire on the basis of the same operation method.The postoperative Mackay score,postoperative imaging Nakamura grade and postoperative complications of the two groups were compared.Results:30 cases in the observation group,with an average last follow-up time of(3.11±0.93)years;38 cases in the control group were followed up for an average of(3.70±1.02)years.There was significant difference in shelving time between the two groups(P<0.05),and there was no significant difference in other preoperative data;There was no significant difference in Mackay score and imaging rating of elbow after operation(P>0.05).Conclusions:For the surgical treatment of Missed Monteggia fractures in children,there is little difference in the overall prognosis between the use of fixation of the humerus and radius joint,but for the cases of Missed Monteggia fractures with a long time from injury to operation,the fixation of the radial head is more conducive to the stability of the humerus and radius joint and has a better curative effect.

关 键 词：陈旧性孟氏骨折 尺骨截骨 内固定 儿童 

分 类 号：R68[医药卫生—骨科学]