摘要
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。
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.
出处
《中国骨伤》
CAS
2014年第10期862-865,共4页
China Journal of Orthopaedics and Traumatology
关键词
儿童
MONTEGGIA骨折
骨间前神经损伤
手法
骨科
Child
Monteggia＇s fracture
Anterior interosseous nerve（AIN） injury
Manipulation,orthopaedics
