前侧入路切开复位Y形支撑钢板内固定治疗儿童孟氏骨折伴有桡神经损伤的效果观察  

Effect of an anterior approach open reduction and Y-shaped support plate internal fixation in the treatment of Monteeggzia fractures with radial nerve injury in children

作　　者：吴雅梅 张艳[1] 夏艳玲 WU Yamei;ZHANG Yan;XIA Yanling(Department of Orthopaedics,Tangshan Second Hospital,Tangshan 063000,China)

机构地区：[1]唐山市第二医院骨科,063000

出　　处：《国际骨科学杂志》2024年第4期277-281,共5页International Journal of Orthopaedics

摘　　要：目的 分析前侧入路切开复位Y形支撑钢板内固定治疗儿童孟氏骨折伴有桡神经损伤的效果。方法 将2021年2月至2022年4月接治的76例儿童孟氏骨折伴有桡神经损伤患儿纳入研究,根据治疗方法不同分为3组,其中A组(25例)采用手法复位石膏固定治疗,B组(25例)采用切开复位钢板内固定治疗(不探查肱桡关节),C组(26例)采用前侧入路切开复位Y形支撑钢板内固定联合探查肱桡关节治疗。所有患者治疗后均接受随访,记录术后骨折愈合时间和桡骨小头脱位、肘关节功能、肱骨功能及桡神经功能情况。结果 C组患儿桡骨小头脱位率明显低于A组和B组,差异具有统计学意义(P<0.05)。3组患儿骨折愈合时间无明显差异(P>0.05)。治疗后C组患儿肘关节功能优良率明显高于A组和B组,差异具有统计学意义(P<0.05)。治疗后C组患儿反射状态、屈伸协同运动、分离运动评分明显优于A组和B组,差异均具有统计学意义(P<0.05)。治疗后3组患儿桡神经功能优良率差异无统计学意义(P>0.05)。结论 超声检查辅助前侧入路切开复位Y形支撑钢板内固定联合肱桡关节探查治疗儿童急性孟氏骨折伴有桡神经损伤的肘关节功能优良率高,肱骨功能恢复显著,同时避免了桡骨小头脱位,应用价值显著。Objective The effect of an anterior approach open reduction and Y-shaped support plate internal fixation in the treatment of children with Monteggia fracture complicated by radial nerve injury was analyzed.Methods Seventy-six children with a radial nerve injury due to a Monteggia fracture who were treated from February 2021 to April 2022 were included in the study and divided into three groups according to the treatment method.Group A(n=25)was treated with manual reduction plaster fixation,group B(n=25)was treated with open reduction plate internal fixation(without probing humeroradial joint),and group C(n=26)was treated with an open reduction Y-shaped support plate and internal fixation combined with exploration of the humeroradial joint using an anterior approach.All patients had follow-up evaluations after treatment,and the time of fracture healing,dislocation of the radial head,function of the elbow joint,and humerus and radial nerve function were recorded.Results The radial head dislocation rate in group C was significantly lower than groups A and B(P<0.05).There was no significant difference in fracture healing time among the three groups(P>0.05).The excellent elbow joint function rate in group C was significantly higher than in groups A and B(P<0.05).The reflex status,flexion and extension cooperative movement,and separation movement scores in group C were significantly better than groups A and group B(P<0.05).There was no significant difference in the excellent and good radial nerve function rates among the three groups(P>0.05).Conclusion An ultrasonic-assisted anterior approach open reduction and Y-shaped support plate internal fixation combined with humeroradial joint exploration in the treatment of children with an acute Monteggia fracture and radial nerve injury has high excellent and good elbow joint rates,significant humeral function recovery,avoidance of radial head dislocation,and significant application value.

关 键 词：孟氏骨折 儿童 桡神经损伤 超声检查 钢板内固定 

分 类 号：R68[医药卫生—骨科学]