成人合并桡骨头骨折的后孟氏骨折脱位的手术治疗及其预后

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Abstract Objective To explore the surgical methods and clinical prognosis of posterior Monteggia fracture-dislocations in adults with radial head fracture.Methods A retrospective study was made on the postoperative functional recovery of 18 adult patients with posterior Monteggia fracture-dislocations with radial head fracture in our hospital.There were 14 males and 4 females，11 left elbows and 7 right elbows，with an average age of (37.6±10.6) years.According to Jupiter’s classification，there were 12 cases of type ⅡA，4 cases of type ⅡC and 2 cases of type ⅡD.Radial head fractures were classified according to Mason’s classification，including 11 cases of type Ⅲ，5 cases of type Ⅱ and 2 cases of type Ⅰ.Ulnas were fixed with olecranon anatomical locking plate in 15 cases(6 cases were combined with Kirschner wire and 8-shaped tension band) and straight locking plate in 3 cases.There were 3 cases of radius head replacement，13 cases of plate screw or hollow screw internal fixation and 2 cases without internal fixation.Results 16 cases were followed up for an average of (15.3±5.9)months.Elbow flexion and extension averaged (103.8±23.1)° and rotation averaged (99.1±23.3)°.The average score of MEPS was (83.4±13.5)，and the excellent and good rate was 81.3% according to the MEPS.Two of the 16 patients had bone nonunion after operation.Conclusion The principle of surgical treatment of posterior Monteggia fracture-dislocations in adults with radial head fracture is to restore the length of ulna and the geometric shape of radial head and ensure the anatomical reduction of joint.The key is to deal with all coronal process-related injuries.Radial head replacement can prevent the fusion of radius and ulna after operation，and intraoperative rigid and sufficient internal fixation can reduce the incidence of nonunion.

Key words： elbow joint fractures dislocation fractures fixation prognosis

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	Articles by authors
	You Yanliang 1
	Ren Yuqi 2*
	Huang Jiale 2
	et al

Cite this article:

You Yanliang 1,Ren Yuqi 2*,Huang Jiale 2, et al. Surgical Treatment and Prognosis of Posterior Monteggia Fracture dislocations in Adults with Radial Head Fracture[J]. sygkzz, 2019, 25(12): 1057-1061.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2019/V25/I12/1057

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