摘要
Abstract
Objective To evaluate the clinical effect of"umbrella-shaped triple-needle"intramedullary fixation with Kirschner wires in the treatment of fresh Bado Ⅲ Monteggia fracture in children.Methods The clinical data of 18 cases with fresh Bado Ⅲ Monteggia fracture admitted from January 2018 to May 2022 was analyzed retrospectively.Closed reduction and intramedullary fixation of"umbrella shaped triple-needle"with percutaneous Kirschner wires were performed.The activity of elbow joint,forearm rotation,brachioradial joint alignment,ulnar force line,callus of X-ray score and fracture healing were followed up after operation.The elbow joint function was assessed by Mayo elbow performance score(MEPS)at the last follow-up.Results The operation was successful in all cases.The average operation time was(40.50±5.54)min,the intraoperative reduction was 1 to 2 times,the intraoperative fluoroscopy was 7 to 12 times.Plaster fixation was removed(22.00±1.79)d after operation,and Kirschner wires were removed(46.94±7.06)d after operation.During 6 to 12 months of follow-up,there was no complications such as pin site infection,needle tail irritation,ischemic muscle contracture,epiphyseal injury,myositis ossificans,fracture nonunion and delayed union.Compared with the first follow-up after the removal of plaster,the elbow joint motion,forearm rotation motion and callus score of X-ray were significantly improved at the last follow-up(P＜0.001).All fractures achieved imaging healing with normal brachioradial joint alignment and ulnar force line recovery.According to MEPS,the elbow function showed that excellence was in 17 children,good in 1 child,and the fineness rate was 100％.Conclusion The intramedullary fixation of"umbrella-shaped triple-needle"is a simple,reliable and minimally invasive method for fresh Bado Ⅲ Monteggia fracture in children,which can enhance the stability of fracture reduction and promote the function recovery of elbow joint and forearm.关键词
Monteggia骨折/尺骨骨折/骨折脱位/骨折固定术,髓内/儿童Key words
Monteggia fractures/ulna fractures/fracture dislocation/fracture fixation,intramedullary/child
