中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2009年
7期
52-53
,共2页
孟氏骨折%畸形%早期%矫形
孟氏骨摺%畸形%早期%矯形
맹씨골절%기형%조기%교형
Monteggia fracture%Deformation%Nonage Orthopedic
目的 探讨早期手术矫形治疗儿童孟氏骨折愈合后畸形的临床效果.方法 本组17例,全部采用肘后外侧切口.方法 一:切断尺骨并作相应延长及植骨,使肱桡关节复位;方法 二:切断桡骨,复位肱桡关节后作相应短缩.重建环状韧带,并用克氏针暂时同定肱桡关节,石膏托外固定前臂于屈肘100°中立位.结果 随访13～27个月,本组17例均基本获得桡骨头复位,肘关节稳定而无明显疼痛.功能恢复情况较为良好,大致接近于肢体的正常活动范围.结论对儿童孟氏骨折后畸形早期采取积极的矫形治疗措施,使桡骨头复位,矫正尺骨畸形,恢复正常的关节组合,对患儿的正常发育是有利的.即使骨与关节已有变形,在成长期也可获得重新塑型的机会.因此积极矫形较等待观望的态度更有价值.
目的 探討早期手術矯形治療兒童孟氏骨摺愈閤後畸形的臨床效果.方法 本組17例,全部採用肘後外側切口.方法 一:切斷呎骨併作相應延長及植骨,使肱橈關節複位;方法 二:切斷橈骨,複位肱橈關節後作相應短縮.重建環狀韌帶,併用剋氏針暫時同定肱橈關節,石膏託外固定前臂于屈肘100°中立位.結果 隨訪13～27箇月,本組17例均基本穫得橈骨頭複位,肘關節穩定而無明顯疼痛.功能恢複情況較為良好,大緻接近于肢體的正常活動範圍.結論對兒童孟氏骨摺後畸形早期採取積極的矯形治療措施,使橈骨頭複位,矯正呎骨畸形,恢複正常的關節組閤,對患兒的正常髮育是有利的.即使骨與關節已有變形,在成長期也可穫得重新塑型的機會.因此積極矯形較等待觀望的態度更有價值.
목적 탐토조기수술교형치료인동맹씨골절유합후기형적림상효과.방법 본조17례,전부채용주후외측절구.방법 일:절단척골병작상응연장급식골,사굉뇨관절복위;방법 이:절단뇨골,복위굉뇨관절후작상응단축.중건배상인대,병용극씨침잠시동정굉뇨관절,석고탁외고정전비우굴주100°중립위.결과 수방13～27개월,본조17례균기본획득뇨골두복위,주관절은정이무명현동통.공능회복정황교위량호,대치접근우지체적정상활동범위.결론대인동맹씨골절후기형조기채취적겁적교형치료조시,사뇨골두복위,교정척골기형,회복정상적관절조합,대환인적정상발육시유리적.즉사골여관절이유변형,재성장기야가획득중신소형적궤회.인차적겁교형교등대관망적태도경유개치.
Objective To stody the clinic effect of treating the Deformation after Monteggia fracture healing with the orthopedic operation in nonage. Methods All expose the fracture of the ulna and the disloca-tion of the radial head through the Boyd incision. 17 cases of thedeformation were treated with two method, the one is cut off and extend ulna with bone graft, reduce humeroradial joint, theother is cut off and deeurtate radius and reest humeroradial joint, then re-establish annular ligament and fixed humeroradial joint with Kirschner wire temporarily,forearm is external fixation with plaster slab on crooked elbow I00° neutral position. Results The follow-up period for 13 to 27 months, 17 cases were all obtained the head of radius resetting fundamentally. The elbow-joint is stabilization and painless obviously and the functional rehabilitation is well fairly. Conclusion The orthopedic operation is favourable for the acromegalic normal development in nonage, that the head of radius is resetted, the ulna malformation is corrected, the normal article combination is recovered. Even though bone and joint is deformation,it can obtained occasion to renew molding in growth period. It is more valuable for active re-shaping than wait-and-see expecting for this reason.
