小型外固定架治疗儿童新鲜孟氏骨折  

Mini external fixator for fresh Monteggia fractures in children

作　　者：戎帅 滕勇[2] 郑冲 刘连涛 甄可培 李浩 申晓宇 冯建书[1] 李锋[1] 李克伟[1] RONG Shuai;TENG Yong;ZHENG Chong;LIU Lian-tao;ZHEN Ke-pei;LI Hao;SHEN Xiao-yu;FENG Jian-shu;LI Feng;LI Ke-wei(Third Hospital of Shijiazhuang City,Shijiazhuang 050000,China;General Hospital of Xinjiang Military Region,Urumqi 830000,China)

机构地区：[1]石家庄市第三医院,河北石家庄050000 [2]新疆军区总医院,新疆乌鲁木齐830000

出　　处：《中国矫形外科杂志》2022年第11期1035-1038,共4页Orthopedic Journal of China

基　　金：石家庄市科学技术研究与发展指导计划项目(编号:171462323);新疆维吾尔自治区区域协同创新专项计划项目(编号:2019E0277)。

摘　　要：[目的]评价小型外固定架在儿童新鲜孟氏骨折中的应用效果。[方法]本研究共纳入12例新鲜儿童孟氏骨折患儿,术中给予骨折复位,行小型外固定架固定,应用关节造影评估复位效果,术后给予前臂旋后位石膏固定。[结果]所有患儿均顺利完成手术,无相关并发症。12例患儿均获得随访6~12个月。末次随访时肘关节屈伸活动范围(range of motion, ROM)及前臂旋转ROM均较术后4周显著增加(P<0.05)。末次随访时根据Mayo肘关节评分标准,临床结果优11例,良1例,优良率100%。影像方面,术后12例均达到满意肱桡对合和尺骨力线恢复,末次随访时,肱桡对合和尺骨力线均无改变(P>0.05)。术后4周复查X线片断端均可见骨痂形成,影像骨折愈合时间8~12周。[结论]对于儿童新鲜孟氏骨折采用小型外固定架固定为有效的治疗方法,其操作简单,创伤小。[Objective] To evaluate the clinical outcomes of mini external fixator for fresh Monteggia fracture in children. [Methods] A total of 12 children with Monteggia fractures were enrolled in this study. Intraoperative fracture reduction and external fixation with a mini frame were conducted in all the children, additionally elbow arthrography intraoperatively was used if necessary to evaluate the reduction,followed by postoperative forearm plaster cast in supination. [Results] All the children were successfully operated without related complications, and were followed up for 6~12 months. The range of motion(ROM) of the elbow flexion-extension and the ROM of forearm rotation were significantly increased at the last follow-up compared with those at 4 weeks after operation(P<0.05). According to the Mayo elbow score at the latest follow-up, the clinical outcomes were marked as excellent in 11 cases and good in 1 case, with excellent/good rate of 100%. Radiographically, all the 12 patients achieved satisfactory recovery of humeroradial congruence and ulna alignment after surgery,which remained unchanged until the latest follow-up(P>0.05). The X-ray films showed callus formation at fracture site as early as 4 weeks after the operation, with sound fracture healing time on the images ranged from 8 to 12 weeks. [Conclusion] This mini external fixator is an effective treatment for fresh Monteggia fracture in children, with benefits of simplifying operation and minimizing iatrogenic trauma.

关 键 词：新鲜孟氏骨折 儿童 小型外固定架 关节造影 肘关节 

分 类 号：R687[医药卫生—骨科学]