Department of Orthopaedic Surgery, Tufts Medical Center, Boston.
Division of Hand and Upper Extremity Surgery, Newton-Wellesley Hospital, Newton, MA.
Tech Hand Up Extrem Surg. 2020 Jul 17;25(2):111-115. doi: 10.1097/BTH.0000000000000307.
Posterior Monteggia fracture-dislocations are uncommon injuries that can result from a fall onto an outstretched hand. Often, these injuries are associated with coronoid and/or radial head fractures. When this is the case, direct fixation can require 3 separate fascial incisions: posterior to address the proximal ulnar fracture, lateral to address the radial head fracture, and medial to address the coronoid fracture. We illustrate a transolecranon surgical approach for fixation of a type IIA posterior Monteggia fracture-dislocation with associated radial head and coronoid fractures. In this approach, the 3 associated fractures can be addressed through a single posterior incision, thereby minimizing soft tissue disruption around the elbow.
后孟氏骨折脱位并不常见，可因摔倒后手撑地所致。此类损伤常合并有冠突和/或桡骨头骨折。在这种情况下，直接固定可能需要 3 个单独的筋膜切口：后方用于处理尺骨近端骨折，外侧用于处理桡骨头骨折，内侧用于处理冠突骨折。我们展示了一种经鹰嘴的手术入路，用于治疗伴有桡骨头和冠突骨折的 IIA 型后孟氏骨折脱位。在这种方法中，通过单个后方切口可以处理 3 处相关骨折，从而最大限度地减少肘部周围的软组织损伤。
