Chen BS,Wang S,Shen Y..Surgical treatment of pediatric acute Monteggia fracture with radial nerve injury.[J].Journal of Clinical Pediatric Surgery,,18():136-140.
Surgical treatment of pediatric acute Monteggia fracture with radial nerve injury.
Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R]
volume:
第18卷
Number:
2019 02
Page:
136-140
Column:
论著
Date of publication:
2019-02-25
- CLC:
- R726.8 R683.41
- Document code:
- A
- Abstract:
- ObjectiveTo explore the surgical approaches of pediatric acute Monteggia fracture associated with radial nerve injury and examine the application of emergency ultrasonography in treating pediatric acute Monteggia fracture with radial nerve injury.MethodsA retrospective study was conducted in 41 cases of pediatric acute Monteggia fracture with radial nerve injury from January 2010 to January 2017.After a definite diagnosis of acute Monteggia fracture with radial nerve injury was made through physical examinations and imaging studies,closed reduction and casting were initially performed.When radial head dislocation could not be close or unstably reduced,flexion casting was applied for stable reduction of radial head.Emergency ultrasound was used for confirming radial nerve injury.For nerve compression phenomenon,emergency surgical open reduction and radial nerve releasing were performed.The approaches were closed reduction casting (n=29) and surgery (n=12).There were 5 boys and 7 girls with an average age of 5.9 (3~11) years.The involved side was left (n=6) and right (n=6).According to the Bados classification,the clinical types were Ⅰ(n=9),Ⅱ(n=1) and Ⅲ(n=2).The average time from injury to surgery time was 6.8 (4~18) hours.Extrusion injury was found intraoperatively.The postoperative status was evaluated for fracture healing/reduction,elbow joint movement and radial nerve injury recovery.ResultsAll Monteggia fractures were stably reduced and healed excellently without nonunion.During an average followup period of 2.4 (1~6) years,none showed a redislocation of radial head.The symptoms of radial nerve injury disappeared.The average recovery time of radial nerve function was 75(70~90) days.Muscle strength became fully restored and elbow joint activity returned to normal.According to the BrobergMorreys rating criteria,the outcome was excellent (n=11) and good (n=1).Excellent and good rate was 100%.ConclusionFor pediatric acute Monteggia fracture with radial nerve injury,when radial head dislocation can not be close or unstably reduced,flexion casting is applied for stable reduction of radial head.Ultrasonic guidance may facilitate emergency surgery and postoperative recovery outcome is excellent.
Last Update:
2019-02-26