CAJ | 학술논문

目的对小儿孟氏骨折脱位及陈旧性孟氏骨折的传统治疗方法、创伤病理解剖、治疗结果及发生漏诊、误诊、误治的病例进行研究。以找到解决问题的方法，提高疗效。方法对170例孟氏骨折脱位患儿的致病原因、治疗方法、术中所见、手术方式以及治疗效果等进行研究、分析。结果83例中，优59例，良15例，一般9例，差5例。结论①孟氏骨折脱位的定义应为：尺骨干骨折合并桡-肱及桡-尺脱位，合并/或不合并桡骨上1/3骨折、桡骨颈骨折、桡骨头骨折脱位；②尺骨鹰嘴骨折合并肘关节脱位不应诊断为孟氏骨折；③提出“超伸直型”孟氏骨折的概念；④尺骨骨折的稳妥治疗及坚强内固定是治疗孟氏骨折的关键；⑤桡骨颈骨折既要对位好，更要对线好，以免以后发生旋转障碍；⑥急诊患儿可行环状韧带修补术及关节囊紧缩术，晚期患儿应行关节囊紧缩术，不主张行环状韧带重建术。
목적대소인맹씨골절탈위급진구성맹씨골절적전통치료방법、창상병리해부、치료결과급발생루진、오진、오치적병례진행연구。이조도해결문제적방법，제고료효。방법대170례맹씨골절탈위환인적치병원인、치료방법、술중소견、수술방식이급치료효과등진행연구、분석。결과83례중，우59례，량15례，일반9례，차5례。결론①맹씨골절탈위적정의응위：척골간골절합병뇨-굉급뇨-척탈위，합병/혹불합병뇨골상1/3골절、뇨골경골절、뇨골두골절탈위；②척골응취골절합병주관절탈위불응진단위맹씨골절；③제출“초신직형”맹씨골절적개념；④척골골절적은타치료급견강내고정시치료맹씨골절적관건；⑤뇨골경골절기요대위호，경요대선호，이면이후발생선전장애；⑥급진환인가행배상인대수보술급관절낭긴축술，만기환인응행관절낭긴축술，불주장행배상인대중건술。
Objective To establish better treatment for Monteggia fracture by studying the traditional management, traumatic anatomy, treatment efficacy, and misdiagnosed cases of Monteggia fracturedislocation and old Monteggia fracture in children. Methods 170 children with Monteggia fracture-dislocation were examined in terms of causes, treatment, intraoperative findings, operational techniques and efficacy etc. Results Of 83 cases treated, the results were excellent in 59, good in 15, fair in 9 and poor in ?. Conclusions (1) The Monteggia fracture-dislocation should be defined as fracture of ulna combined with radiohumeral and radioulnar dislocation, with or without dislocation of fracture of upper one third,neck of radius, and head of radius. (2) The Monteggia fracture should not cover fracture of ulnar olecranon combined with elbow dislocation. (3) A 攕uper-straight type?Monteggie fracture concept was proposed.(4) The careful treatment of fracture of ulna and firm internal fixation are the keys of treatment of Monteggia fracture. (5) For the treatment of fracture of neck of radius, linear as well as positional alignment should be achieved to avoid later development of rotation disorder. (6) For emergency cases of juvenile Monteggia fracture, repair of anular ligaments can be performed and reefing of joint capsule can be done for late stage cases. Reconstruction of anular ligaments is not recommended.