Wang S T, Wang N H, Chin L S, Lo W H
Department of Orthopedics and Traumatology, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1996 Nov;58(5):355-8.
Monteggia fracture rarely occurs in children. If it occurs, type I fracture is most commonly seen. We study the functional results of nonsurgical management in acute cases.
From July, 1988 through October, 1994, we encountered 15 cases of acute Monteggia fractures, accounting for 2.3% of forearm fractures. Twelve were males and three were females, at an average age of 7 years and 10 months. Nine fractures occurred on left non-dominant side, six occurred on right dominant side. There were eleven type I (73.3%), no type II, three type III (20%), and one type IV (6.7%) fractures. All of these patients received closed reduction with long arm casting, and the most stable position of fracture was supination of the forearm and flexion of the elbow.
After follow-up for an average of 45.9 months, all fractures were found to unite without residual deformity of ulna or dislocation of the radial head. The functional results were excellent. Posterior interosseous nerve palsy occurred in one patient before treatment, and recovered spontaneously.
Unlike adults, children with Monteggia fractures can get excellent results from closed reduction with long arm casting.
孟氏骨折在儿童中很少见。如果发生，I型骨折最为常见。我们研究了急性病例非手术治疗的功能结果。
从1988年7月至1994年10月，我们共遇到15例急性孟氏骨折，占前臂骨折的2.3%。其中男性12例，女性3例，平均年龄7岁10个月。9例骨折发生在左侧非优势手，6例发生在右侧优势手。I型骨折11例（73.3%），无II型骨折，III型骨折3例（20%），IV型骨折1例（6.7%）。所有这些患者均接受了长臂石膏固定闭合复位，骨折最稳定的位置是前臂旋后和肘关节屈曲。
平均随访45.9个月后，所有骨折均愈合，尺骨无残留畸形，桡骨头无脱位。功能结果良好。1例患者在治疗前出现骨间后神经麻痹，后自行恢复。
与成人不同，儿童孟氏骨折采用长臂石膏固定闭合复位可取得良好效果。
