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环状韧带重建联合内固定治疗孟氏骨折的疗效分析

[Analysis of curative effect of reconstruction of annular ligament combined with internal fixation for the treatment of Monteggia fracture].

作者信息

Huang Li, Chen Xiang, Lin Wei, Li Zhi-Peng, Huang Hao, Huang Chen

机构信息

Huangshi TCM Hospital, Huangshi 435000, Hubei, China;

Huangshi TCM Hospital, Huangshi 435000, Hubei, China.

出版信息

Zhongguo Gu Shang. 2018 May 25;31(5):477-479. doi: 10.3969/j.issn.1003-0034.2018.05.015.

Abstract

OBJECTIVE

To investigate the curative effect of fascia reconstruction of annular ligament combined with internal fixation for the treatment of Monteggia fracture.

METHODS

From December 2014 to October 2016, 30 cases with Monteggia fracture were treated by fascia reconstruction of annular ligament combined with internal fixation including 18 males and 12 females with an average age of 34.6 years old ranging from 6 to 50 years old. Elbow joint function were evaluated according to Mackay efficacy evaluation criteria.

RESULTS

All 30 patients were followed up for an average of 12.5 months. No radial head re-dislocation occurred. Internal fixation of reconstructive plate of ulna were all bone healing. According to the evaluation standard of Mackay curative effect, 23 cases were excellent, 5 cases were good, and 2 cases were poor. There were 4 cases of mild elbow pain and no pain in the wrist joint. Functional recovery was the fastest and most satisfactory in the forearm. Eight cases had dysfunction of elbow extension with an average limitation of 9.1 degrees. Six cases delayed injury of radial nerve were recovered for half a year.

CONCLUSIONS

For the Monteggia fracture, fascia reconstruction of annular ligament combined with internal fixation can effectively restore the forearm rotation function, the recent effect is satisfactory, further observation is needed for the long-term effect.

摘要

目的

探讨环状韧带筋膜重建联合内固定治疗孟氏骨折的疗效。

方法

2014年12月至2016年10月,对30例孟氏骨折患者采用环状韧带筋膜重建联合内固定治疗,其中男性18例,女性12例,平均年龄34.6岁,年龄范围6至50岁。根据麦凯疗效评估标准对肘关节功能进行评估。

结果

30例患者均获随访,平均随访12.5个月。无桡骨头再脱位发生。尺骨重建钢板内固定均骨性愈合。根据麦凯疗效评估标准,优23例,良5例,差2例。肘关节轻度疼痛4例,腕关节无疼痛。前臂功能恢复最快且最满意。8例肘关节伸直功能障碍,平均受限9.1度。6例桡神经迟发性损伤半年后恢复。

结论

对于孟氏骨折,环状韧带筋膜重建联合内固定能有效恢复前臂旋转功能,近期疗效满意,远期疗效有待进一步观察。

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