[Surgical treatment and function rehabilitation of Monteggia fracture in children].
OBJECTIVE
To establish better treatment for Monteggia fracture by evaluating the operative effect and function rehabilitation in children.


METHODS
From 1994 to 2001, 78 children with Monteggia fracture (30 cases of new fracture, 48 cases of old fracture) were treated with open reduction and internal fixation. The patients were randomly divided into two groups. In the first group (45 cases, 16 new and 29 old), radius-humeral joint was fixed with a Kirschner wire after reduction and without fixation of ulna fracture; in the second group(33 cases, 14 new and 19 old), both radiohumeral joint and ulna fracture were fixed with Kirschner wire. Two groups were treated with plaster-splint after operation. The effect of operation was evaluated according to the function criteria for bending elbow and rotation of forearm.


RESULTS
All patients were followed up 6 months to 7 years (4.6 years on average). All wound healed well without bone nonunion, delayed union and infection after operation. In the first group, 37 cases were rated as excellent, 5 good and 3 poor. The effective rate was 93.3%. In the second group, 22 cases were rated as excellent, 7 good and 4 poor. The effective rate was 87.9%. There was no significant difference between two groups (P > 0.05).


CONCLUSIONS
Surgical treatment is the choice for Monteggia fracture in children. It should be treated with single Kirschner wire fixing after open reduction of radiohumeral and plaster-splint. This method is simple, safe and has satisfactory results in fracture healing and function rehabilitation after operation.
Li
Ming
M
Department of Orthopedics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China 400014.
Zhang
De-wen
DW
Liu
Zheng-quan
ZQ
Long
Hai-bing
HB
Ou
Yang-jun
YJ
Ma
Xue
X
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D008297:Male; D009011:Monteggia's Fracture / Q000534:rehabilitation* / Q000601:surgery*; D016896:Treatment Outcome