Gu Zhenkun,Zhang Chen,Li Jiahui,et al.Clinical management of pediatric Monteggia fractures:a single-center experience of 1 129 cases[J].Journal of Clinical Pediatric Surgery,,():1056-1060.[doi:10.3760/cma.j.cn101785-202502022-012]
Clinical management of pediatric Monteggia fractures:a single-center experience of 1 129 cases
- Keywords:
- Ulna Fractures; Peripheral Nerve Injuries; Epidemiology; Child
- Abstract:
- Objective To explore the clinical characteristics of pediatric Monteggia fractures treated surgically at a single center. Methods Retrospective analysis was conducted for 1129 children operated for Monteggia fractures between January 2013 and December 2023.Personal demographics,injury mechanisms and surgical profiles were descriptively analyzed.Furthermore,potential associations were explored between Bado classification,presence of nerve injury and fracture type (open/closed). Results This cohort comprised of 740 boys and 389 girls.The highest incidence was recorded in 3 to 6-year-old age group (50.3%,568/1 129).The most predominant cause of injury was falling from a height of under 1 meter (88.7%,1 001/1 129).Closed reduction with Kirschner wire internal fixation was the most commonly performed surgical procedure (92.2%,1 101/1 129).The most common complication was acute nerve injury,occurring in 16.3% of cases (184/1 129).According to the Bado classification,type Ⅲ was the most prevalent (43.8%,495/1 129),followed by type Ⅰ (35.1%,396/1 129),type Ⅱ (17.9%,202/1 129) and type Ⅳ (3.2%,36/1 129).No significant association was identified between Bado classification and nerve injury (χ2=2.381,P>0.05).However,a statistically significant association occurred between nerve injury and whether or not fracture was open or closed (χ2=5.284,P=0.034).Inter-observer reliability for Bado classification was excellent among orthopedic surgeons (κ=0.947). Conclusions Children aged 3-6 years are at the highest risk for Monteggia fractures due to low-energy falls.Bado type Ⅲ fracture is the most common variant.Acute nerve injury is a frequent complication.It is imperative to attach great importance to meticulous neurological assessments,particularly in children with open fractures.
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Memo
收稿日期:2025-2-11。
基金项目:深圳市医疗卫生三名工程项目(SZSM202011012)
通讯作者:唐盛平,Email:tangshengping56@126.com