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1、中华骨科杂志2006年1月第26卷第1期ChinJOrthop,January2006,Vol.26,No.1·13··临床研究·成人孟氏骨折脱位分型与预后的关系张国柱蒋协远王满宜荣国威【摘要】目的探讨成人孟氏骨折脱位的Bado分型与预后的关系。方法自1994年1月至2004年1月,对获得随访的60例成人孟氏骨折脱位患者的临床资料进行分析,男41例,女19例;平均年龄为29岁(14～54岁)。其中BadoⅠ型骨折脱位26例,BadoⅡ型骨折脱位14例,BadoⅢ型骨折脱位19例,BadoⅣ型骨折脱位1例。尺骨骨折采用切开复位钢板螺钉内固定,桡骨
2、头骨折采用切开复位内固定或桡骨头部分、全部切除术。不合并骨折的桡骨头脱位大多行闭合复位石膏固定,合并桡神经损伤者未行手术探查。统计学研究采用非典型数据统计分析系统(NoSA)的秩和检验。结果术后随访12～72个月,平均24个月。按Broberg和Morrey评分系统,BadoⅠ型,24例评分为满意,2例不满意,满意率为92%;BadoⅡ型,10例满意,4例不满意,满意率为71%;BadoⅢ型19例,结果均为满意(100%),1例BadoⅣ骨折脱位结果满意。统计学检验各组在骨折预后方面差异无统计学意义。合并桡骨头骨折组与未合并桡骨头骨折组之间,患
3、者的预后差异有统计学意义。结论Bado分型对于骨折的预后没有指导意义。在成人孟氏骨折中,是否合并桡骨头骨折对治疗结果影响较大。【关键词】肘关节;桡骨骨折;分类法;预后TherelationshipbetweentheclassificationoftheMonteggiadislocation-fractureinadultanditsprognosisZHANGGuo-zhu,JiangXie-yuan,WANGMan-yi,etal.DepartmentofOrthopaedics,BeijingJishuitanHospital,Beij
4、ing100035,China【Abstract】ObjectiveTostudytherelationshipbetweentheBado'sclassificationoftheMonteggiafractureinadultandtheirprognosis.MethodsStudyingthe60patientsinourhospitalsufferingfromMon-teggiafracture-dislocationduring10yearsbetween1994to2004,andtheirclinicaldataofthefo
5、llow-upisanalysisedwithstatistics.Therewere26caseswithBadotypeⅠfracture-dislocations,14caseswithBadotypeⅡfracture-dislocations,19caseswithBadotypeⅢand1casewithBadotypeⅣfracture-disloca-tions.Thefracturesoftheshaftoftheulnaweretreatedoperativelywithopenreductionandinternalfix
6、ationusingplatesandscrews.Thefracturesoftheradialheadwereoperatedwithopenreductionandinternalfix-ation,oraretreatedwiththeresectionofthepartialortotalradialhead.Forthecasesofthedislocationoftheradialheadwithoutfracture,themostcommonlyusedtreatmentmethodwastoreducethedislocat
7、ioncloselyandstablethepositionwithexternalfixationbyaplastercast.Fortheinjuryoftheradialnerveas-sociatedwiththeMonteggiafracturedislocation,nooperationhadbeendonetomakeanexploration.RankSunTestofNoSAsystemwasadoptedtoanalysistheclinicaldatagainedabove.ResultsTheaveragedu-rat
8、ionofthefollow-upwas24months(12-72months).Theresultsweregradedaccordingtoth
