阔筋膜重建环状韧带结合内固定治疗孟氏骨折

目的:探讨阔筋膜重建环状韧带结合内固定治疗孟氏骨折的临床疗效。方法 :2014年12月至2016年10月收治孟氏骨折30例,其中男18例,女12例;年龄6~50岁,平均34.6岁;30例均行阔筋膜重建环状韧带结合内固定手术。根据Mackay疗效评定标准评价肘关节功能。结果:30例获得平均12.5个月随访,无桡骨头再发脱位,尺骨重建钢板内固定全部骨性愈合。根据Mackay疗效评定标准评价,优23例,良5例,差2例。4例出现轻度肘关节疼痛,无腕关节疼痛病例。功能恢复以前臂活动最快、最满意。8例伸肘功能障碍,平均受限9.1°,6例合并桡神经迟发损伤者术后半年全部恢复。结论:对于孟氏骨折,阔筋膜重建环状韧带结合内固定手术能有效恢复前臂旋转功能,近期疗效满意,远期效果有待进一步观察。

Analysis of curative effect of reconstruction of annular ligament combined with internal fixation for the treatment of Monteggia fracture

Objective: To investigate the curative effect of fascia reconstruction of annular ligament combined with internal fixation for the treatment of Monteggia fracture.Methods: From December 2014 to October 2016, 30 cases with Monteggia fracture were treated by fascia reconstruction of annular ligament combined with internal fixation including 18 males and 12 females with an average age of 34.6 years old ranging from 6 to 50 years old. Elbow joint function were evaluated according to Mackay efficacy evaluation criteria.Results: All 30 patients were followed up for an average of 12.5 months. No radial head re-dislocation occurred. Internal fixation of reconstructive plate of ulna were all bone healing. According to the evaluation standard of Mackay curative effect, 23 cases were excellent, 5 cases were good, and 2 cases were poor. There were 4 cases of mild elbow pain and no pain in the wrist joint. Functional recovery was the fastest and most satisfactory in the forearm. Eight cases had dysfunction of elbow extension with an average limitation of 9.1 degrees. Six cases delayed injury of radial nerve were recovered for half a year.Conclusion: For the Monteggia fracture, fascia reconstruction of annular ligament combined with internal fixation can effectively restore the forearm rotation function, the recent effect is satisfactory, further observation is needed for the long-term effect.