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手法复位治疗小儿孟氏骨折合并骨间前神经损伤
Hits: 1865   Download times: 1070   Received:February 20, 2014    
作者Author单位UnitE-Mail
李海明 LI Hai-ming 山西医科大学第二附属医院骨科, 山西 太原 030001 Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China lhmjqx@sohu.com 
柳晓军 LIU Xiao-jun 平陆县中医医院, 山西 平陆 044300  
期刊信息:《中国骨伤》2014年27卷,第10期,第862-865页
DOI:10.3969/j.issn.1003-0034.2014.10.015


目的:探讨手法复位保守治疗小儿孟氏骨折合并骨间前神经损伤的疗效。

方法:2010年10月至2013年4月,手法复位屈曲旋后位固定治疗39例小儿孟氏骨折合并骨间前神经损伤,男22例,女17例;年龄3.2~11岁,平均6.3岁;右侧15例,左侧24例。病程40 min~8 d,平均1.5 d.滑板伤7例,摔伤13例,坠落伤11例,气垫床伤8例。按Bado孟氏骨折损伤分型:Ⅱ型13例,Ⅲ型22例,Ⅳ型4例。

结果:术后3周食指远节活动正常34例,术后6周活动均正常。39例均获得随访,时间54 d~6个月,平均67 d.按Mayo肘关节功能评价标准,活动范围(19.62±1.35)分,疼痛(45.00±0.00)分,稳定性(9.87±0.80)分,肌力(25.00±0.00)分,总分(99.49±1.92)分;评价结果均为优。

结论:骨间前神经损伤经早期发现、及时合理综合治疗可逐渐恢复功能,疗效良好。提高骨间前神经损伤认识可有效减少漏诊。
[关键词]:儿童  Monteggia骨折  骨间前神经损伤  手法,骨科
 
Manual reduction of children’s Monteggia fractures associated with anterior interosseous nerve injury
Abstract:

Objective: To study clinical results of the manual reduction in treatment.

Methods: From October 2010 to April 2013,39 children with Monteggia fracture associated with anterior interosseous nerve injury were treated by manual reduction and fixation on buckling rotation backward,including 17 females and 22 males with an average age of 6.3 years old ranging from 3.2 to 11 years old. Among them,15 cases were on the right side and 24 cases on the left. The course of disease was 40 minutes to 8 days(averaged 1.5 days). There were 7 cases with skateboard injured,13 cases with stumble injured,11 cases with falling injured,8 cases with air bed injured. According to Bado classification,13 cases were type Ⅱ,22 cases were type Ⅲ,4 cases were type Ⅳ.

Results: The distal forefinger showed exercise normally in 34 cases at 3 weeks after treatment,and the patients restored normal activities at 6 weeks after treatment. All patients were follow-up from 54 days to 6 months(averaged 67 days. According to Mayo elbow functional evaluation standard,the scoring result was 19.62±1.35 in activity,45.00±0.00 in pain,9.87±0.80 in stability,25.00±0.00 in strength,99.49±1.92 in total. The outcome of all patients was excellent and good evaluation results.

Conclusion: If the anterior interosseous nerve injury could be identified early and treated timely,patients could gradually restore reasonable function and recover with satisfactory results. Raising understanding of anterior interosseous nerve injury can effectively reduce misdiagnosis.
KEYWORDS:Child  Monteggia’s fracture  Anterior interosseous nerve(AIN) injury  Manipulation,orthopaedics
 
引用本文,请按以下格式著录参考文献:
中文格式:李海明,柳晓军.手法复位治疗小儿孟氏骨折合并骨间前神经损伤[J].中国骨伤,2014,27(10):862~865
英文格式:LI Hai-ming,LIU Xiao-jun.Manual reduction of children’s Monteggia fractures associated with anterior interosseous nerve injury[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(10):862~865
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