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目的总结小儿陈旧性孟氏骨折初次手术失败后再手术治疗的经验及临床治疗效果。方法采用手术治疗的小儿陈旧性孟氏骨折初次手术失败患儿18例,对其临床资料进行回顾性分析。结果 18例患儿均行尺骨斜行截骨矫形、环状韧带重建手术,术后均得到随访,随访时间为12~42个月,平均时间为24个月。手术效果根据Mackay病情评估标准,优11例,良6例,差1例,优良率达94%。结论小儿陈旧性孟氏骨折初次手术失败后再手术治疗关键在于矫正尺骨畸形,采用尺骨斜行截骨矫形、环状韧带重建,可取得满意的临床效果。
Objective To summarize the experience and clinical effects of surgical treatment after the initial failure of Monteggia fracture in children. Methods Twenty-eight children with failed primary Monteggia fracture surgery underwent surgical treatment. The clinical data were retrospectively analyzed. Results All the 18 children underwent oblique osteotomy and lumbar reconstruction. The patients were followed up for 12 to 42 months with an average of 24 months. According to the evaluation criteria of Mackay disease, the results were excellent in 11 cases, good in 6 cases and poor in 1 case, the excellent and good rate was 94%. Conclusions The key to reoperation after the initial operation in children with old Monteggia fracture is to correct the ulnar deformity. Satisfactory results can be obtained by using oblique oblique osteotomy and reconstruction of annulus ligament.