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[孟氏骨折及类孟氏骨折]

[Monteggia and Monteggia-like Injuries].

作者信息

Goth Anna, Klug Alexander, Hoffmann Reinhard

出版信息

Z Orthop Unfall. 2025 Jun;163(3):279-295. doi: 10.1055/a-2550-3007. Epub 2025 Jun 4.

DOI:10.1055/a-2550-3007
PMID:40467046
Abstract

Monteggia-(like)-lesions are a combination injury of the forearm characterised by a proximal ulnar fracture with concomitant dislocation of the radial head in the proximal radioulnar joint (PRUG). If there are also fractures of the radial head and/or the coronoid, these are referred to as Monteggia-like injuries. Monteggia(-like) injuries are serious lesions which, without adequate treatment, carry a high risk of permanent damage such as persistent movement restrictions, progressive osteoarthritis and pain. Adequate diagnosis and treatment are essential for a satisfactory postoperative outcome. CT imaging with 3D reconstruction is the gold standard for preoperative diagnosis and planning. Generally, anatomical reduction with osteosynthesis is the treatment of choice for Monteggia(-like) injuries. In the vast majority of cases, the surgical approach can be dorsal. Anatomical fixation of the ulnar fracture is crucial for surgical success and is usually achieved using (locking) plate osteosynthesis. Concomitant fractures of the radial head and/or coronoid as well as ligamentous injuries require special attention and should usually also be addressed.

摘要

孟氏(类)损伤是一种前臂复合伤,其特征为尺骨近端骨折并伴有桡骨头在近端桡尺关节(PRUG)脱位。如果同时存在桡骨头和/或冠突骨折,则称为类孟氏损伤。孟氏(类)损伤是严重损伤,若未得到充分治疗,会有永久性损伤的高风险,如持续的活动受限、进行性骨关节炎和疼痛。充分的诊断和治疗对于获得满意的术后结果至关重要。三维重建CT成像为术前诊断和规划的金标准。一般来说,解剖复位内固定是孟氏(类)损伤的首选治疗方法。在绝大多数情况下,手术入路可选择背侧。尺骨骨折的解剖固定对手术成功至关重要,通常采用(锁定)钢板内固定来实现。同时存在的桡骨头和/或冠突骨折以及韧带损伤需要特别关注,通常也应予以处理。

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