EFFECTIVENESS OF MODIFIED OPERATION FOR TREATMENT OF OLD MONTEGGIA FRACTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 WEIShizhan , TANGYujin , PENGWeibo , BANHuadeng

Department of Orthopedics, Affiliated Hospital of Youjiang Medical College for Nationalities, Baise Guangxi, 533000, P. R. China;

Corresponding?author：

WEIShizhan, Email: WShZh6611@163.com

Keywords：

Old Monteggia fracture; Osteotomy; Bone graft; Annular ligament; Fixation

DOI：

10.7507/1002-1892.20160011

Video：

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Objective To investigate the effectiveness of a modified surgical treatment of old Monteggia fracture. Methods Between March 2006 and December 2013, 40 cases of old Monteggia fracture were treated with modified operation. Modified operation procedure included expanding excision of pedicled forearm fascia flap for reconstruction of the annular ligament and repair of elbow radial lateral collateral ligament complex and extending osteotomy of the ulna, callus replantation, and internal fixation with steel plate. There were 26 boys and 14 girls, aged 2-10 years with an average age of 4 years. Injury was caused by falling in 24 cases, by traffic accident in 8 cases, and by falling from height in 8 cases. The disease duration was 2-11 months (mean, 4 months). Four patients had combined radial nerve palsy. Results Incision healed by first intention after operation, without early complication of radial nerve palsy, fascial compartment syndrome, or decreased hand extensor muscle strength. All the children were followed up 1-5 years (mean, 2.5 years). X-ray films showed fracture healing, and the healing time was 10-20 weeks (mean, 15 weeks). During follow-up, 3 cases had re-dislocation. Neither hand dysfunction caused by hand muscle adhesion nor radial head bottleneck shape change was found. On the basis of the functional evaluation criteria by Mackay, the results were excellent in 32 cases, good in 5 cases, and poor in 3 cases; the excellent and good rate was 92.5% at last follow-up. Conclusion The modified surgical treatment of old Monteggia fracture is an effective method, with good matching of humeroradial joint and without internal fixation of the humeroradial joint.

Citation： WEIShizhan, TANGYujin, PENGWeibo, BANHuadeng. EFFECTIVENESS OF MODIFIED OPERATION FOR TREATMENT OF OLD MONTEGGIA FRACTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(1): 50-53. doi: 10.7507/1002-1892.20160011 Copy

1.	曾裴.兒童陳舊孟氏骨折治療現狀和展望.中國矯形外科雜志, 2013, 21(10):981-983.
2.	Fernandez FF. Proximale unterarm-und Radiushalsverletzungen beim Kind. Trauma und Berufskrankheit, 2014, 16(1):61-67.
3.	Mackay I, Fiezgerald B, Miller JH. Silastic replacement of the head of the radius in trauma. J Bone Joint Surg (Br), 1979, 61-B(4):494-497.
4.	黃金承,連鴻凱,白玉,等.尺骨截骨加克氏針固定肱橈關節治療兒童陳舊性孟氏骨折.臨床小兒外科雜志, 2013, 12(3):178-180.
5.	Pesl T, Havránek P. Monteggia lesions in the growing skeleton:princeles of therapy. Acta Chir Orthop Traumatol Cech, 2010, 77(1):32-38.
6.	Eamsobhana P, Kaewpornsawan K. Chronic Monteggia lesions treatment with open reduction and Z-lengthening technique with annular ligament reconstruction. J Med Assoc Thai, 2013, 95 Suppl 9:47-53.
7.	王華明,陳志龍,李衛平,等.兒童陳舊性孟氏骨折:需要重建環狀韌帶嗎?中國組織工程研究, 2013, 17(35):6357-6363.
8.	胥少汀,葛寶豐,徐印坎.實用骨科學. 4版.北京:人民軍醫出版社, 2012:5-59.
9.	李志,何裔,鐘剛,等.兒童創傷性孤立性橈骨頭脫位伴環狀韌帶損傷修復重建的研究進展.中國修復重建外科雜志, 2011, 25(1):1266-1268.
10.	李忠,劉雪濤,張成進,等.兒童陳舊性孟氏骨折的手術改良.中國矯形外科雜志, 2007, 15(12):938-939.
11.	丁盛,楊彥才,徐振,等.兒童陳舊性孟氏骨折30例臨床分析.創傷外科雜志, 2013, 15(2):171-172.
12.	王磊,袁泉,鄧超.特殊型孟氏骨折38例的治療分析.華西醫學, 2010, 25(11):2068-2069.
13.	蔣協遠,李庭.肘部創傷的治療進展與思考.中國骨傷, 2014, 27(11):887-890.
14.	張志群,樓躍,唐凱,等.兒童陳舊性孟氏骨折的手術治療體會(附28例報告).南京醫科大學學報:自然科學版, 2013, 33(11):1569-1571.
15.	李明,張德文,劉正全,等.兒童孟氏骨折的治療.中華骨科雜志, 2004, 24(6):342-345.
16.	何濤貞,孫小艷,江君,等.兒童陳舊性橈骨小頭脫位的治療.中國修復重建外科雜志, 2014, 28(8):929-931.
17.	黃文文,彭昊,尹東,等.手術治療陳舊性孟氏骨折療效分析.生物醫學工程與臨床, 2013, 17(3):262-365.
18.	鄭志剛,馬長生,楊澤晉,等.低齡兒童2年以內陳舊性孟氏骨折的手術治療.臨床骨科雜志, 2014, 17(5):549-551.
19.	陳勝偉,張玉生,刁慶勛,等.尺骨成角延長截骨治療兒童陳舊性孟氏骨折.臨床骨科雜志, 2015, 18(2):219-221.

1. 曾裴.兒童陳舊孟氏骨折治療現狀和展望.中國矯形外科雜志, 2013, 21(10):981-983.
2. Fernandez FF. Proximale unterarm-und Radiushalsverletzungen beim Kind. Trauma und Berufskrankheit, 2014, 16(1):61-67.
3. Mackay I, Fiezgerald B, Miller JH. Silastic replacement of the head of the radius in trauma. J Bone Joint Surg (Br), 1979, 61-B(4):494-497.
4. 黃金承,連鴻凱,白玉,等.尺骨截骨加克氏針固定肱橈關節治療兒童陳舊性孟氏骨折.臨床小兒外科雜志, 2013, 12(3):178-180.
5. Pesl T, Havránek P. Monteggia lesions in the growing skeleton:princeles of therapy. Acta Chir Orthop Traumatol Cech, 2010, 77(1):32-38.
6. Eamsobhana P, Kaewpornsawan K. Chronic Monteggia lesions treatment with open reduction and Z-lengthening technique with annular ligament reconstruction. J Med Assoc Thai, 2013, 95 Suppl 9:47-53.
7. 王華明,陳志龍,李衛平,等.兒童陳舊性孟氏骨折:需要重建環狀韌帶嗎?中國組織工程研究, 2013, 17(35):6357-6363.
8. 胥少汀,葛寶豐,徐印坎.實用骨科學. 4版.北京:人民軍醫出版社, 2012:5-59.
9. 李志,何裔,鐘剛,等.兒童創傷性孤立性橈骨頭脫位伴環狀韌帶損傷修復重建的研究進展.中國修復重建外科雜志, 2011, 25(1):1266-1268.
10. 李忠,劉雪濤,張成進,等.兒童陳舊性孟氏骨折的手術改良.中國矯形外科雜志, 2007, 15(12):938-939.
11. 丁盛,楊彥才,徐振,等.兒童陳舊性孟氏骨折30例臨床分析.創傷外科雜志, 2013, 15(2):171-172.
12. 王磊,袁泉,鄧超.特殊型孟氏骨折38例的治療分析.華西醫學, 2010, 25(11):2068-2069.
13. 蔣協遠,李庭.肘部創傷的治療進展與思考.中國骨傷, 2014, 27(11):887-890.
14. 張志群,樓躍,唐凱,等.兒童陳舊性孟氏骨折的手術治療體會(附28例報告).南京醫科大學學報:自然科學版, 2013, 33(11):1569-1571.
15. 李明,張德文,劉正全,等.兒童孟氏骨折的治療.中華骨科雜志, 2004, 24(6):342-345.
16. 何濤貞,孫小艷,江君,等.兒童陳舊性橈骨小頭脫位的治療.中國修復重建外科雜志, 2014, 28(8):929-931.
17. 黃文文,彭昊,尹東,等.手術治療陳舊性孟氏骨折療效分析.生物醫學工程與臨床, 2013, 17(3):262-365.
18. 鄭志剛,馬長生,楊澤晉,等.低齡兒童2年以內陳舊性孟氏骨折的手術治療.臨床骨科雜志, 2014, 17(5):549-551.
19. 陳勝偉,張玉生,刁慶勛,等.尺骨成角延長截骨治療兒童陳舊性孟氏骨折.臨床骨科雜志, 2015, 18(2):219-221.

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EFFECTIVENESS OF MODIFIED OPERATION FOR TREATMENT OF OLD MONTEGGIA FRACTURE

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