Department of Orthopedic Surgery, Keimyung University, Joong-gu, Daegu, Korea.
J Orthop Trauma. 2012 Oct;26(10):597-601. doi: 10.1097/BOT.0b013e3182548981.
The purpose of this study was to report the long-term follow-up results of chronic Monteggia fractures treated with angulation-translation osteotomy of ulna and closed reduction of the radial head.
Retrospective.
Level 1 trauma center.
We retrospectively reviewed 10 missed Monteggia fractures in children. The mean age of the patients was 7.5 years (range, 6-10 years), and there were 2 girls and 8 boys. The mean duration of time between initial injury and initial presentation was 1.7 years (range, 6 weeks to 5 years).
Closed reduction with ulna osteotomy or lengthening was performed in all 10 cases. Annular ligament reconstruction (ALR) was done in 2 cases. Final follow-up ranged from 3 to 20 years (mean 10 years).
We assessed preoperative and postoperative radiographs to evaluate the quality of the radial head reduction. Clinical results were assessed according to the functional elbow score devised by Kim et al.
Radial head reduction was achieved and maintained in 8 of 10 cases after primary or secondary surgery. The radial head was mildly subluxated in one case and dislocated in another case at final follow-up. ALR was performed in only 2 cases. Open reduction and ALR is not required in every case, and its need should depend on intraoperative stability of radial head.
本研究旨在报告采用尺骨成角-平移截骨和桡骨头闭合复位治疗慢性孟氏骨折的长期随访结果。
回顾性研究。
1 级创伤中心。
我们回顾性分析了 10 例儿童漏诊的孟氏骨折。患者的平均年龄为 7.5 岁（范围为 6-10 岁），其中 2 例为女性，8 例为男性。初次受伤至初次就诊的平均时间为 1.7 年（范围为 6 周至 5 年）。
所有 10 例均行闭合复位伴尺骨截骨或延长。2 例行环状韧带重建（ALR）。最终随访时间为 3 至 20 年（平均 10 年）。
我们评估术前和术后 X 线片，以评估桡骨头复位质量。根据 Kim 等人制定的功能性肘评分评估临床结果。
8 例患者在初次或二次手术后实现并维持了桡骨头复位，1 例轻度半脱位，另 1 例在最终随访时脱位。仅 2 例患者行 ALR。并非每个病例都需要切开复位和 ALR，其需求应取决于桡骨头的术中稳定性。
