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成人ⅡA型孟氏骨折脱位合并同侧桡骨远端骨折——一种罕见的关联情况

Type IIA Monteggia Fracture Dislocation with Ipsilateral Distal Radius Fracture in Adult - A Rare Association.

作者信息

Kembhavi Raghavendra S, James Boblee

机构信息

Assistant Professor, Department of Orthopaedics, Sree Lakshmi Narayana Institute of Medical Sciences , Pondicherry, India .

Professor, Department of Orthopaedics, Sree Lakshmi Narayana Institute of Medical Sciences , Pondicherry, India .

出版信息

J Clin Diagn Res. 2016 Aug;10(8):RD01-3. doi: 10.7860/JCDR/2016/20841.8323. Epub 2016 Aug 1.

Abstract

Monteggia fracture constitutes about 5-10% of the forearm fractures. Monteggia fracture by definition is proximal ulnar fracture with disruption of proximal radioulnar joint. Bado classified Monteggia fracture dislocation into four types and Jupiter subclassified type II Bado's fractures into four types. The associated injury in the form of distal radial fractures and distal humerus fractures are rare though many cases of distal radial physeal injuries have been reported in paediatric population. Hereby we report a rare association of type IIA Monteggia fracture dislocation with ipsilateral distal radius fracture in an adult patient. This case report also highlights on proper examination and full length radiographs of forearm to avoid missing injury at wrist in cases of elbow injuries. Management of such complex injuries included open reduction and internal fixation of olecronon fracture, distal radius fracture and radial head resection. Functional outcome at six months was good at wrist whereas at elbow, stiffness was a major concern with elbow range of movement from 40°-110°.

摘要

孟氏骨折约占前臂骨折的5%-10%。根据定义,孟氏骨折是尺骨近端骨折伴近端桡尺关节脱位。巴多将孟氏骨折脱位分为四种类型,朱庇特又将巴多II型骨折细分为四种类型。桡骨远端骨折和肱骨远端骨折形式的相关损伤很少见,不过儿科人群中有许多桡骨远端骨骺损伤的病例报道。在此,我们报告一例成年患者罕见的IIA型孟氏骨折脱位合并同侧桡骨远端骨折。本病例报告还强调了在前臂损伤时进行适当检查和拍摄前臂全长X线片以避免漏诊腕部损伤的重要性。此类复杂损伤的治疗包括尺骨鹰嘴骨折切开复位内固定、桡骨远端骨折切开复位内固定及桡骨头切除术。六个月时的功能结果显示,腕部情况良好,而肘部则主要存在僵硬问题,肘关节活动范围为40°-110°。

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