环状韧带修复对儿童陈旧性孟氏骨折的影响  

Effect of repairing of annular ligament on the pediatric chronic Monteggia fracture

作　　者：杨曦 徐永清 刘武华 许育健 石岩 方翔 何晓清 Yang Xi;Xu Yongqing;Liu Wuhua;Xu Yujian;Shi Yan;Fang Xiang;He Xiaoqing(Department of Orthopedics,the 920th Hospital of Joint Logistic Support Force of Chinese PLA,Kunming 650032,Yunnan Province,China)

机构地区：[1]解放军联勤保障部队第九二〇医院骨科,昆明650032

出　　处：《中国临床解剖学杂志》2023年第4期470-474,共5页Chinese Journal of Clinical Anatomy

基　　金：云南省卫健委临床中心建设重大项目(ZX20191001)。

摘　　要：目的探讨环形韧带修复对儿童陈旧性孟氏骨折尺骨截骨术预后的影响。方法回顾2013年3月至2022年1月收治的30例陈旧性孟氏骨折患儿的病例资料,采用单纯尺骨截骨矫形17例(A组),联合环状韧带修复13例(B组)。末次手术后随访13~96个月,平均随访18个月。按照Kim评分标准、肘关节活动度及影像学结果分析其预后。结果按照Kim功能评分标准,术后两组优良率比较差异无统计学意义(P>0.05)。肘关节总活动度两组比较,差异无统计学意义(P>0.05);X光片结果显示30例截骨端均愈合良好,28例肱桡关节复位良好,2例术后桡骨头向外侧轻度半脱位。结论尺骨延长-成角是治疗儿童陈旧性孟氏骨折的关键,此基础上环形韧带修复不是预后的决定性因素。Objective To evaluate the effect of repairing of annular ligament in the treatment of pediatric chronic Monteggia fracture based on ulnar osteotomy.Methods Between March 2013 to January 2022,a retrospective case series study was conducted to analyze 30 children with chronic Monteggia fracturedislocations.In all cases were treated with open reduction of the radial head and lengthening-angulation osteotomy of ulnar,in of which 17 cases underwent only lengthening-angulation osteotomy of ulna(Group A),13 combined annular ligament repairing(Group B).Following up was performed for mean 18(range,12 to 96)months postoperatively.The outcome was evaluated by the Kim score and range of motion,and radiography.Results There was no statistical difference in the excellent-and-good rate between group A and group B(P>0.05),according to Kim score.There was no statistical difference in the total elbow range of motion between group A and group B(P>0.05).There were no complications of nonunion in follow-up radiographs.Relocation of radiocapitellar joint were observed in 28 cases,radial head subluxation recurred in 2 cases.Conclusions Lengthening-angulation osteotomy of ulna is the key in the treatment of chronic Monteggia fractures,on the basis of which the repairing of annular ligament is not a major determinant for prognosis.

关 键 词：陈旧性孟氏骨折 桡骨头脱位 尺骨截骨 环状韧带 儿童 

分 类 号：R726.1[医药卫生—儿科]