Rodgers W B, Waters P M, Hall J E
Department of Orthopaedic Surgery, Harvard Medical School, Boston Children's Hospital, Massachusetts 02115, USA.
J Bone Joint Surg Am. 1996 Sep;78(9):1322-9. doi: 10.2106/00004623-199609000-00005.
We retrospectively reviewed the results of operative treatment of chronic Monteggia lesions (Bado type I or the equivalent) with anterior radiocapitellar dislocation in seven patients. The mean age at the time of the reconstruction was six years and nine months (range, eleven months to twelve years), and the mean time from the injury to the operation was twelve months (range, five weeks to thirty-nine months). The mean duration of follow-up was four years and six months (range, two years to eleven years and three months). There were fourteen complications, including malunion of the ulnar shaft in one patient; residual radiocapitellar subluxation in two patients (one anterior and one posterolateral); radiocapitellar dislocation (dynamic anterior subluxation of the radial head in supination) in one patient; transient ulnar-nerve palsy in three patients (with residual weakness in two); partial laceration of the radial nerve in one patient; loss of the fixation in two patients; and non-union of the ulnar osteotomy site, compartment syndrome, conversion reaction, and possible fibrous synostosis of the forearm in one patient each. The patients lost a mean of 36 degrees of pronation and a mean of 27 degrees of supination of the forearm compared with the contralateral, uninjured extremity. Two patients demonstrated a loss of flexion of the elbow of 8 and 13 degrees and three had a loss of extension (mean, 15 degrees) compared with the contralateral side. There were three good, two fair, and two poor results.
我们回顾性分析了7例慢性孟氏骨折（巴多I型或类似类型）合并桡骨头前脱位患者的手术治疗结果。重建时的平均年龄为6岁9个月（范围为11个月至12岁），受伤至手术的平均时间为12个月（范围为5周至39个月）。平均随访时间为4年6个月（范围为2年至11年3个月）。共出现14例并发症，包括1例尺骨干骨不连；2例桡骨头残留半脱位（1例为前侧，1例为后外侧）；1例桡骨头脱位（旋前时桡骨头动态前半脱位）；3例短暂性尺神经麻痹（2例有残留无力）；1例桡神经部分撕裂；2例内固定失败；1例尺骨截骨部位骨不连、骨筋膜室综合征、转换反应以及1例前臂可能的纤维性骨桥形成。与对侧未受伤肢体相比，患者前臂旋前平均丧失36°，旋后平均丧失27°。与对侧相比，2例患者肘关节屈曲分别丧失8°和13°，3例患者肘关节伸展丧失（平均15°）。结果为优3例，良2例，差2例。
