儿童孟氏骨折骨间背侧神经卡压的临床研究

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1、PosteriorinterosseousnerveentrapmentafterMonteggiafracture-dislocationinchildrenLiHai(DepartmentofPediatricOrthopaedics,Xin-HuaHospital,ShanghaiJiaotongUniversitySchoolofMedicine,ShangHai200092)Abstract:ObjectAlthoughmostofnerveinjuriesassociatedwithMonteggiafracture-dislocationinchi

2、ldrenareneurapraxiasandwillrecoverspontaneouslyafterconservativetreatment,surgicalexplorationoftheinvolvednerveisalwaysrequiredinthecaseswiththeentrapmentofposteriorinterosseousnerve(PIN).However,thenecessityandtimeframeforsurgicalinterventionforspecificpatternsofnervedysfunctionrema

3、inscontroversial.MethodsEightcases,sixboysandtwogirls,withMonteggiafracture-dislocationcomplicatedbyPINinjury,managedoperativelyattheauthors5hospitalfrom2007to2008wereretrospectivelyreviewed・Allthepatientsunderwenttheattemptedclosedreduction,beforetheyreceivedexplorationofPIN,withope

4、nreductionandinternalfixationorsuccessfulclosedreduction.ResultsThePINwasfoundtobetrappedacutelyposteriortotheradiocapitellarjointin4outof5TypeIIIBado'sMonteggiafractures.Intheremainingcases,sincetherewerelongertimeintervalsfrominjurytooperation,chroniccompressivechangesandepineuralf

5、ibrosisofradialnervewerevisualized.Afteramicrosurgicalneurolysisperformed,thecompleterecoveryinthenervefunctionwasobtainedinallthecasesduringthefollow-up.ConclusionThefindingsfromthisstudysuggestthateverycaseoftypeIIIMonteggiafracture-dislocationwithdecreasedorabsentfunctionofmuscles

6、innervatedbythePINandanirreducibleradialheadinchildshouldbeviewedasanindicationforimmediatesurgicalexplorationoftheinvolvednervetoexcludeapotentialPINentrapment.Keywords:Monteggiafracture-dislocation;posteriorinterosseousnerve;entrapment;pediatric0IntroductionMonteggiafracture-disloc

7、ationwasdescribedbyGiovanniMonteggiaapproximately2hundredyearsago,asfractureofproximal1/3ofulnainassociationwithanteriordislocationofradialheadm.Radialnervepalsy,whichmostlyinvolvesposteriorinterosseousnerve(PIN),isarecognizedsequelofMonteggiafracture-dislocation.Theincidenceofradial

8、nervepalsyre