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

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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.	黄金承,连鸿凯,白玉,等.尺骨截骨加克氏针固定肱桡关节治疗儿童陈旧性孟氏骨折.临床小儿外科杂志, 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.	王华明,陈志龙,李卫平,等.儿童陈旧性孟氏骨折:需要重建环状韧带吗?中国组织工程研究, 2013, 17(35):6357-6363.
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9.	李志,何裔,钟刚,等.儿童创伤性孤立性桡骨头脱位伴环状韧带损伤修复重建的研究进展.中国修复重建外科杂志, 2011, 25(1):1266-1268.
10.	李忠,刘雪涛,张成进,等.儿童陈旧性孟氏骨折的手术改良.中国矫形外科杂志, 2007, 15(12):938-939.
11.	丁盛,杨彦才,徐振,等.儿童陈旧性孟氏骨折30例临床分析.创伤外科杂志, 2013, 15(2):171-172.
12.	王磊,袁泉,邓超.特殊型孟氏骨折38例的治疗分析.华西医学, 2010, 25(11):2068-2069.
13.	蒋协远,李庭.肘部创伤的治疗进展与思考.中国骨伤, 2014, 27(11):887-890.
14.	张志群,楼跃,唐凯,等.儿童陈旧性孟氏骨折的手术治疗体会(附28例报告).南京医科大学学报:自然科学版, 2013, 33(11):1569-1571.
15.	李明,张德文,刘正全,等.儿童孟氏骨折的治疗.中华骨科杂志, 2004, 24(6):342-345.
16.	何涛贞,孙小艳,江君,等.儿童陈旧性桡骨小头脱位的治疗.中国修复重建外科杂志, 2014, 28(8):929-931.
17.	黄文文,彭昊,尹东,等.手术治疗陈旧性孟氏骨折疗效分析.生物医学工程与临床, 2013, 17(3):262-365.
18.	郑志刚,马长生,杨泽晋,等.低龄儿童2年以内陈旧性孟氏骨折的手术治疗.临床骨科杂志, 2014, 17(5):549-551.
19.	陈胜伟,张玉生,刁庆勋,等.尺骨成角延长截骨治疗儿童陈旧性孟氏骨折.临床骨科杂志, 2015, 18(2):219-221.

1. 曾裴.儿童陈旧孟氏骨折治疗现状和展望.中国矫形外科杂志, 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. 黄金承,连鸿凯,白玉,等.尺骨截骨加克氏针固定肱桡关节治疗儿童陈旧性孟氏骨折.临床小儿外科杂志, 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. 王华明,陈志龙,李卫平,等.儿童陈旧性孟氏骨折:需要重建环状韧带吗?中国组织工程研究, 2013, 17(35):6357-6363.
8. 胥少汀,葛宝丰,徐印坎.实用骨科学. 4版.北京:人民军医出版社, 2012:5-59.
9. 李志,何裔,钟刚,等.儿童创伤性孤立性桡骨头脱位伴环状韧带损伤修复重建的研究进展.中国修复重建外科杂志, 2011, 25(1):1266-1268.
10. 李忠,刘雪涛,张成进,等.儿童陈旧性孟氏骨折的手术改良.中国矫形外科杂志, 2007, 15(12):938-939.
11. 丁盛,杨彦才,徐振,等.儿童陈旧性孟氏骨折30例临床分析.创伤外科杂志, 2013, 15(2):171-172.
12. 王磊,袁泉,邓超.特殊型孟氏骨折38例的治疗分析.华西医学, 2010, 25(11):2068-2069.
13. 蒋协远,李庭.肘部创伤的治疗进展与思考.中国骨伤, 2014, 27(11):887-890.
14. 张志群,楼跃,唐凯,等.儿童陈旧性孟氏骨折的手术治疗体会(附28例报告).南京医科大学学报:自然科学版, 2013, 33(11):1569-1571.
15. 李明,张德文,刘正全,等.儿童孟氏骨折的治疗.中华骨科杂志, 2004, 24(6):342-345.
16. 何涛贞,孙小艳,江君,等.儿童陈旧性桡骨小头脱位的治疗.中国修复重建外科杂志, 2014, 28(8):929-931.
17. 黄文文,彭昊,尹东,等.手术治疗陈旧性孟氏骨折疗效分析.生物医学工程与临床, 2013, 17(3):262-365.
18. 郑志刚,马长生,杨泽晋,等.低龄儿童2年以内陈旧性孟氏骨折的手术治疗.临床骨科杂志, 2014, 17(5):549-551.
19. 陈胜伟,张玉生,刁庆勋,等.尺骨成角延长截骨治疗儿童陈旧性孟氏骨折.临床骨科杂志, 2015, 18(2):219-221.

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EFFECTIVENESS OF MODIFIED OPERATION FOR TREATMENT OF OLD MONTEGGIA FRACTURE

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