目的探讨两种手术方法对儿童陈旧性伸直型孟氏骨折的疗效。方法将70例陈旧性伸直型孟氏骨折患儿分成A、B 2组各35例,A组患者采用尺骨截骨延长矫形术治疗,未行环状韧带重建;B组患者采用尺骨截骨延长矫形术治疗,行环状韧带重建,比较2组优...目的探讨两种手术方法对儿童陈旧性伸直型孟氏骨折的疗效。方法将70例陈旧性伸直型孟氏骨折患儿分成A、B 2组各35例,A组患者采用尺骨截骨延长矫形术治疗,未行环状韧带重建;B组患者采用尺骨截骨延长矫形术治疗,行环状韧带重建,比较2组优良率。结果术后随访1年~10年,平均4.5年,根据Broberg and Morrey评定标准,A组优25例,良8例,可1例,差1例,优良率为94.2%;B组优21例,良6例,可5例,差3例,优良率为77.1%,2组优良率比较有显著性差异。结论尺骨截骨延长矫形术是治疗陈旧性伸直型孟氏骨折较好的方法,环状韧带无需重建。展开更多
BACKGROUND Traumatic radial head dislocation(RHD)is a well-described injury in the pediatric population.It is usually associated with an injury to the ulna in Monteggia fracture-dislocation,although it can occur as an...BACKGROUND Traumatic radial head dislocation(RHD)is a well-described injury in the pediatric population.It is usually associated with an injury to the ulna in Monteggia fracture-dislocation,although it can occur as an isolated injury.Traumatic RHD with ipsilateral radial shaft fracture has rarely been reported.Delayed RHD secondary to the malunion of an isolated radial shaft fracture is extremely rare.CASE SUMMARY We report a 9-year-old boy with limited pronation of the right elbow.The patient was diagnosed with delayed RHD associated with the malunion of a distal radial fracture.Since the annular ligament was disrupted with forearm rotation causing subluxation of the radial head,a modified double-strip Bell Tawse procedure was performed to reconstruct the annular ligament without corrective osteotomy for the malunited site.Four years after surgery,the angulation deformity of the distal radius was corrected with the restoration of the normal curvature of the radius.There was no recurrence of RHD.CONCLUSION Annular ligament reconstruction without corrective osteotomy could reduce RHD and restore the normal curve of the radial shaft in children with delayed dislocation of the radial head associated with malunion of the radial shaft.Annular reconstruction using double triceps tendon strips might be useful for maintaining a more stable reduction by augmenting anterolateral parts.展开更多
Forearm fractures are prevalent which include radius fractures,ulna fractures,or both radius and ulna fractures.Proximal radius fractures combined with dislocations of the radial heads are rare and easily misdiagnosed...Forearm fractures are prevalent which include radius fractures,ulna fractures,or both radius and ulna fractures.Proximal radius fractures combined with dislocations of the radial heads are rare and easily misdiagnosed.The authors present and discuss a case of proximal radius fractures associated with radial head dislocations.A 36 years old male was admitted to the hospital due to pain and activity limitation in his left elbow for 7 hours due to a car accident.An X-ray of the left elbow joint revealed a“left radius fracture with surrounding soft tissue edema”.During the procedure,the radial head was found to be dislocated forward.A 3.0 mm anchor was used to fix the annular ligament.Radius fractures combined dislocations of the radial heads are rare and may be missing the diagnosis.Before undergoing surgery,the possibility of elbow dislocation should be evaluated.Wire anchors can provide reliable fixation.展开更多
文摘目的探讨两种手术方法对儿童陈旧性伸直型孟氏骨折的疗效。方法将70例陈旧性伸直型孟氏骨折患儿分成A、B 2组各35例,A组患者采用尺骨截骨延长矫形术治疗,未行环状韧带重建;B组患者采用尺骨截骨延长矫形术治疗,行环状韧带重建,比较2组优良率。结果术后随访1年~10年,平均4.5年,根据Broberg and Morrey评定标准,A组优25例,良8例,可1例,差1例,优良率为94.2%;B组优21例,良6例,可5例,差3例,优良率为77.1%,2组优良率比较有显著性差异。结论尺骨截骨延长矫形术是治疗陈旧性伸直型孟氏骨折较好的方法,环状韧带无需重建。
文摘BACKGROUND Traumatic radial head dislocation(RHD)is a well-described injury in the pediatric population.It is usually associated with an injury to the ulna in Monteggia fracture-dislocation,although it can occur as an isolated injury.Traumatic RHD with ipsilateral radial shaft fracture has rarely been reported.Delayed RHD secondary to the malunion of an isolated radial shaft fracture is extremely rare.CASE SUMMARY We report a 9-year-old boy with limited pronation of the right elbow.The patient was diagnosed with delayed RHD associated with the malunion of a distal radial fracture.Since the annular ligament was disrupted with forearm rotation causing subluxation of the radial head,a modified double-strip Bell Tawse procedure was performed to reconstruct the annular ligament without corrective osteotomy for the malunited site.Four years after surgery,the angulation deformity of the distal radius was corrected with the restoration of the normal curvature of the radius.There was no recurrence of RHD.CONCLUSION Annular ligament reconstruction without corrective osteotomy could reduce RHD and restore the normal curve of the radial shaft in children with delayed dislocation of the radial head associated with malunion of the radial shaft.Annular reconstruction using double triceps tendon strips might be useful for maintaining a more stable reduction by augmenting anterolateral parts.
基金The authors acknowledge the financially support received from the Medicine and Health Project of Zhejiang Province(2022KY1288,2022KY1313)General Research Project of Zhejiang Provincial Department of Education(LY202043116,Y202145976)Science and Technology Project of Shaoxing City(2020A13011).
文摘Forearm fractures are prevalent which include radius fractures,ulna fractures,or both radius and ulna fractures.Proximal radius fractures combined with dislocations of the radial heads are rare and easily misdiagnosed.The authors present and discuss a case of proximal radius fractures associated with radial head dislocations.A 36 years old male was admitted to the hospital due to pain and activity limitation in his left elbow for 7 hours due to a car accident.An X-ray of the left elbow joint revealed a“left radius fracture with surrounding soft tissue edema”.During the procedure,the radial head was found to be dislocated forward.A 3.0 mm anchor was used to fix the annular ligament.Radius fractures combined dislocations of the radial heads are rare and may be missing the diagnosis.Before undergoing surgery,the possibility of elbow dislocation should be evaluated.Wire anchors can provide reliable fixation.
