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儿童伴有骨间后神经损伤的Ⅲ型孟氏骨折:一例报告

Type III Monteggia fracture with posterior interosseous nerve injury in a child: A case report.

作者信息

Wang Jing, Chen Min, Du Jiang

机构信息

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China.

出版信息

Medicine (Baltimore). 2017 Mar;96(11):e6377. doi: 10.1097/MD.0000000000006377.

Abstract

RATIONALE

Elbow injury in children by improper treatment or a delay of more than 3 weeks could lead to old unreduced Monteggia fracture, which are difficult to manage. Conservative or normal surgical methods usually fail.

PATIENT CONCERNS

Herein, we present a 6-year-old boy with sustaining injury approximately 1 month to his left elbow. Activity in his elbow was restricted, and his ability to extend his wrist and fingers was impaired.

DIAGNOSES

Type III Monteggia elbow fracture-dislocation consisting of radial head dislocation and malunion of the ulna associated with posterior interosseous nerve palsy were confirmed, which requiring surgical treatment.

INTERVENTIONS

A closed reduction was performed with hyperplastic scar tissues erased and the radial head relocated.

OUTCOMES

Follow-up 4 months later showed satisfactory recovery of function.

LESSONS

Forearm fractures in children may be misjudged, and that early anatomical reduction rather than conservative treatment may be required.

摘要

理论依据

儿童肘部损伤若治疗不当或延误超过3周,可能导致陈旧性未复位孟氏骨折,处理起来较为困难。保守治疗或常规手术方法通常无效。

患者情况

在此,我们报告一名6岁男孩,其左肘部受伤约1个月。肘部活动受限,手腕和手指伸展能力受损。

诊断结果

确诊为Ⅲ型孟氏肘部骨折脱位,包括桡骨头脱位和尺骨畸形愈合,并伴有骨间后神经麻痹,需要手术治疗。

干预措施

进行了闭合复位,清除增生性瘢痕组织并使桡骨头复位。

结果

4个月后的随访显示功能恢复满意。

经验教训

儿童前臂骨折可能被误诊,可能需要早期解剖复位而非保守治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1548/5369935/a59119d48c12/medi-96-e6377-g001.jpg

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