Zhang Rui, Wang Xiaoyu, Xu Jia, Kang Qinglin, Hamdy Reggie C
Department of Orthopedics, Shanghai Jiao Tong University affiliated Sixth People's Hospital, Shanghai, China.
Department of Pediatric Surgery, Montreal General Hospital, Montreal, Quebec, Canada.
EFORT Open Rev. 2022 Apr 21;7(4):287-294. doi: 10.1530/EOR-21-0087.
Monteggia fracture is characterized by radial head dislocation combined with proximal ulnar fracture. If not diagnosed at an early stage, these lesions can gradually lead to forearm deformities and dysfunction, finally resulting in neglected Monteggia fracture. When the radial head is not reduced, several deformities develop at the humeroradial joint, including cubitus valgus and osteoarthritis. Adequate radiographs are crucial when the surgeons deal with forearm injuries. At present, proximal ulnar osteotomy and open reduction of chronic radial head dislocation provides satisfactory functional outcomes because of anatomic alignment reconstruction. Supplementary procedures, including transcapitellar pinning and repair or reconstruction of the annular ligament, which are performed in order to enhance stability of the humeroradial joint, should be thoroughly assessed based on joint rotational stability after reduction and on potential complications.
孟氏骨折的特点是桡骨头脱位合并尺骨近端骨折。如果早期未被诊断,这些损伤会逐渐导致前臂畸形和功能障碍,最终形成陈旧性孟氏骨折。当桡骨头未复位时,肱桡关节会出现多种畸形,包括肘外翻和骨关节炎。外科医生处理前臂损伤时,充分的X线片至关重要。目前,尺骨近端截骨术和慢性桡骨头脱位切开复位术由于重建了解剖对线,能提供满意的功能结果。为增强肱桡关节稳定性而进行的补充手术,包括经肱骨小头穿针以及环状韧带修复或重建,应根据复位后关节旋转稳定性和潜在并发症进行全面评估。