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[儿童孟氏骨折——一项临床试验]

[Monteggia lesions in children--a clinical trial].

作者信息

Kuminack K F, Reising K J, Schmal H, Südkamp N P, Strohm P C

机构信息

Department für Orthopädie und Traumatologie, Klinikum der Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau.

出版信息

Z Orthop Unfall. 2010 Jan;148(1):54-9. doi: 10.1055/s-0029-1186190. Epub 2009 Nov 12.

Abstract

BACKGROUND

The Monteggia lesion is a rare injury of the elbow in children. This lesion is defined as a shaft fracture of the ulna combined with a luxation of the radial head. The primary problem in this injury is the proper diagnosis because the misalignment of the radial head is often missed. The purpose of this study was to retrospectively analyse the results after Monteggia lesions in children.

PATIENTS AND METHODS

Ten children between two and nine years of age (six boys and four girls) were clinically assessed using the Morrey score. They were treated in our department between December 1999 and October 2004.

RESULTS

The Morrey score after 54 months (min.: 26/max.: 84) had a median value of 100 points with 100 being the maximum (min.: 95/max.: 100). We found two complications, a combined lesion of the radial and ulnar nerves which completely recovered after six months. In one case a k-wire dislocated, which was removed earlier.

DISCUSSION

If the Monteggia lesion in children is correctly diagnosed and treated early enough, only good and very good results may be expected. After delayed diagnosis and treatment, the clinical results are not as good or even very poor.

摘要

背景

孟氏骨折是儿童肘部的一种罕见损伤。该损伤定义为尺骨干骨折合并桡骨头脱位。这种损伤的主要问题在于正确诊断,因为桡骨头的错位常常被漏诊。本研究的目的是回顾性分析儿童孟氏骨折的治疗结果。

患者与方法

对10名年龄在2至9岁之间的儿童(6名男孩和4名女孩)采用莫雷评分进行临床评估。他们于1999年至2004年在我们科室接受治疗。

结果

54个月后的莫雷评分(最小值:26/最大值:84),中位数为100分(满分100分)(最小值:95/最大值:100)。我们发现了2例并发症,1例为桡神经和尺神经联合损伤,6个月后完全恢复。另1例克氏针脱位,提前取出。

讨论

如果儿童孟氏骨折得到正确诊断并尽早治疗,预期结果只会是良好或非常好。如果诊断和治疗延迟,临床结果则不会那么好甚至非常差。

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