Ring D, Waters P M
Department of Orthopaedics, Boston Children's Hospital, Massachusetts 02115, USA.
J Bone Joint Surg Br. 1996 Sep;78(5):734-9.
We reviewed 36 consecutive patients with Monteggia fracture-dislocations of the forearm; 28 had been treated within 24 hours and 8 had been referred a week or more after the initial injury with persisting or recurrent dislocation of the proximal radio-ulnar joint after treatment elsewhere. We treated 15 of the 16 complete fractures and 3 of the 11 incomplete fractures of the ulna by operative fixation. All the early fractures and six of the eight late referrals had good or excellent results. The two poor results were in patients with malalignment and dislocation of the radial head persisting for at least two weeks before definitive treatment. A good outcome after a Monteggia injury in a child requires early diagnosis and prompt, stable, anatomical reduction of the ulnar fracture. In our experience, selective operative fixation of unstable fractures provides reliable reduction and causes few complications.
我们回顾了36例连续性前臂孟氏骨折脱位患者；其中28例在受伤24小时内接受治疗，8例在初次受伤一周或更长时间后转诊，这些患者在其他地方接受治疗后近端桡尺关节仍存在持续性或复发性脱位。我们对16例尺骨完全骨折中的15例以及11例尺骨不完全骨折中的3例进行了手术固定治疗。所有早期骨折患者以及8例晚期转诊患者中的6例均取得了良好或优异结果。两例效果不佳的患者是桡骨头对线不良和脱位，在最终治疗前持续了至少两周。儿童孟氏损伤后要取得良好预后需要早期诊断以及对尺骨骨折进行迅速、稳定、解剖复位。根据我们的经验，对不稳定骨折进行选择性手术固定可实现可靠复位且并发症少。
