Kawoosa Altaf A, Dhar Shabir A, Butt Mohammed Farooq, Wani Shareef A, Mir M R, Dar T A
Department of Orthopaedics, Government Medical College, Srinagar, Jammu and Kashmir, India.
J Med Case Rep. 2010 Oct 26;4:344. doi: 10.1186/1752-1947-4-344.
A Monteggia facture dislocation is not an uncommon injury, and the diagnosis can often be missed. Long-term follow-up of untreated Monteggia fracture dislocations reveals development of premature arthritis, pain, instability, and loss of pronation and supination. Methods involving annular ligament reconstruction require post-operative immobilization and use of transcapitellar pinning for maintenance of reduction, and thus a delay in rehabilitation. The literature reports satisfactory results with methods that involve ulnar osteotomy and open reduction of the radial head without annular ligament reconstruction. We used the Ilizarov method in two cases with neglected Monteggia fracture dislocations to stably reduce the radial head without open reduction and annular ligament reconstruction.
We report two cases of neglected Monteggia fracture dislocation, in two Kashmiri boys aged four and six years. Using ulnar osteotomy with distraction osteogenesis, we were able to relocate the radial head gradually and maintain the reduction without a requirement for open reduction and annular ligament reconstruction.
Distraction lengthening and hyperangulation in different planes by use of the Ilizarov technique effectively reduces the radial head without open reduction and annular ligament reconstruction.
孟氏骨折脱位并非罕见损伤，但其诊断常易被漏诊。未经治疗的孟氏骨折脱位长期随访显示会出现过早关节炎、疼痛、不稳定以及旋前和旋后功能丧失。涉及环状韧带重建的方法需要术后固定，并使用经肱骨小头穿针来维持复位，因此会延迟康复。文献报道，采用尺骨截骨和桡骨头切开复位且不进行环状韧带重建的方法取得了满意的效果。我们对两例陈旧性孟氏骨折脱位病例采用了伊里扎洛夫方法，在不进行切开复位和环状韧带重建的情况下稳定地复位了桡骨头。
我们报告两例陈旧性孟氏骨折脱位病例，患者为两名克什米尔男孩，年龄分别为4岁和6岁。通过尺骨截骨并进行牵张成骨，我们能够逐渐使桡骨头复位，并在无需切开复位和环状韧带重建的情况下维持复位。
使用伊里扎洛夫技术在不同平面进行牵张延长和过度成角，可有效复位桡骨头，而无需切开复位和环状韧带重建。
