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成人孟氏等效1型变异体、其治疗及功能预后并文献综述

Monteggia Equivalent Variant Type 1 in an Adult, its Management and Functional Outcome with Literature Review.

作者信息

Mukherjee Soutrik, Parkaviyan R, Banerjee Kallol

机构信息

Department of Orthopaedics, North Bengal Medical College and Hospital, Darjeeling, West Bengal, India.

出版信息

J Orthop Case Rep. 2024 Oct;14(10):163-168. doi: 10.13107/jocr.2024.v14.i10.4848.

Abstract

INTRODUCTION

In 1814, Giovanni Battista Monteggia first described the fracture pattern which was further characterized by Luis Bado in 1967. Bado also coined the term Monteggia equivalent which includes a spectrum of complex fracture patterns and dislocations of the proximal ulna and radius. Monteggia equivalent lesions in adults are rare with different injury mechanisms compared to children, and thus having different management procedures.

CASE REPORT

We report a Type 1 Monteggia equivalent variant in a 31-year-old female who presented with a proximal ulnar fracture along with an ipsilateral radial neck fracture extending into the radial head. A fracture pattern that has not been reported much in literature as per our observations and we suggest should be considered a Monteggia equivalent Type 1b. Osteosynthesis of the ulna and proximal radius was done and at 1-year follow-up, complete radiological union with near-native function was achieved.

CONCLUSION

Early recognition of such complex fracture patterns and a reconstruction of the proximal radius wherever possible gives a better outcome than arthroplasty or excision as per literature.

摘要

引言

1814年,乔瓦尼·巴蒂斯塔·蒙特吉亚首次描述了这种骨折类型,1967年路易斯·巴多对其进行了进一步阐述。巴多还创造了“蒙特吉亚类同损伤”一词,其中包括一系列复杂的骨折类型以及尺骨近端和桡骨的脱位。与儿童相比,成人的蒙特吉亚类同损伤较少见,损伤机制不同,因此治疗方法也不同。

病例报告

我们报告了一名31岁女性的1型蒙特吉亚类同损伤变体病例,该患者表现为尺骨近端骨折,同时伴有同侧桡骨颈骨折并延伸至桡骨头。据我们观察,这种骨折类型在文献中报道不多,我们建议应将其视为1b型蒙特吉亚类同损伤。对尺骨和桡骨近端进行了骨接合术,在1年的随访中,实现了完全的放射学愈合,功能接近正常。

结论

根据文献,早期识别这种复杂的骨折类型并尽可能对桡骨近端进行重建,比关节成形术或切除术能取得更好的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5afd/11458213/6754dde97719/JOCR-14-163-g001.jpg

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