Frontiers in pediatrics · 2026
Comparison of multi-track mini single arm external fixation and plate internal fixation in the treatment of missed Monteggia fracture in children.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Bai Rui, Ding Xiaoli, Chen Hongbo, Bai Zhenyu, Wu Long, Ye Peng
Аннотация
OBJECTIVE: To analyze the effect of multi-track mini single arm external fixation and plate internal fixation in the treatment of missed Monteggia fracture in children.
METHODS: Retrospectively analyzed the data of 22 children with missed Monteggia fracture admitted to the General Hospital of Ningxia Medical University from April 2018 to October 2024. There were 14 males, 8 females, 5 on the left side, and 17 on the right side. Age (5.3 ± 1. 9) years old at the time of injury, 17 cases of Radiocapitellar dislocation forward, 1 case of posterior dislocation, and 4 cases of anterolateral dislocation. The time from injury to surgery was (31.0 ± 11.5) months, and all patients were treated with Boyd's approach multi-track mini single arm external fixation or plate internal fixation. The range of elbow flexion and extension, the range of forearm rotation, the length of operation and the volume during operation, the range of elbow flexion and extension, the range of forearm rotation, the Mayo score of elbow and the healing time of osteotomy were measured and compared in all patients. At the same time, the incidence of complications was recorded.
RESULTS: All patients were followed up for 12 months. There was no statistical difference between the two groups in the range of motion of the elbow joint before operation (p > 0.05). The duration of operation (97.7 ± 4. 9 min) and the volume during operation (47.4 ± 6. 4 mL) in the external fixation group were smaller than those in the internal fixation group (132.8 ± 8. 5 min, 70.3 ± 16. 1 mL), the difference was statistically significant (p < 0.05); At 12 months after operation, the elbow flexion range (127.8 ± 5. 9°), forearm pronation (81.2 ± 3. 3°), and forearm supination (84.2 ± 3. 2°) in the external fixation group were significantly improved compared with the internal fixation group (121.6 ± 7. 1°, 73.2 ± 5. 1°, 80.1 ± 5. 4°), the difference was statistically significant (p < 0.05), and the elbow extension range (0.7 ± 7. 8°) in the external fixation group was not significantly different from the internal fixation group (5.9 ± 8. 3°) (p > 0.05); The Mayo score of elbow joint function in the external fixation group (92.0 ± 7. 1) was better than that in the internal fixation group (86.7 ± 9. 8), the difference was statistically significant (p < 0.05); There was no significant difference in osteotomy healing time between external fixation group (6.8 ± 1. 0 months) and internal fixation group (5.8 ± 1. 6 months) (p > 0.05); The overall complication rate of the two groups was significantly higher in the external fixation group (3 (30.0%)) than that in the internal fixation group (5 (41.7%)) (p > 0.05).
CONCLUSION: Both multi-track mini single arm external fixation and plate internal fixation can effectively treat the missed diagnosis of missed Monteggia fracture in children. The former may have more prominent advantages in operative efficiency and postoperative recovery of elbow flexion and forearm rotation.
METHODS: Retrospectively analyzed the data of 22 children with missed Monteggia fracture admitted to the General Hospital of Ningxia Medical University from April 2018 to October 2024. There were 14 males, 8 females, 5 on the left side, and 17 on the right side. Age (5.3 ± 1. 9) years old at the time of injury, 17 cases of Radiocapitellar dislocation forward, 1 case of posterior dislocation, and 4 cases of anterolateral dislocation. The time from injury to surgery was (31.0 ± 11.5) months, and all patients were treated with Boyd's approach multi-track mini single arm external fixation or plate internal fixation. The range of elbow flexion and extension, the range of forearm rotation, the length of operation and the volume during operation, the range of elbow flexion and extension, the range of forearm rotation, the Mayo score of elbow and the healing time of osteotomy were measured and compared in all patients. At the same time, the incidence of complications was recorded.
RESULTS: All patients were followed up for 12 months. There was no statistical difference between the two groups in the range of motion of the elbow joint before operation (p > 0.05). The duration of operation (97.7 ± 4. 9 min) and the volume during operation (47.4 ± 6. 4 mL) in the external fixation group were smaller than those in the internal fixation group (132.8 ± 8. 5 min, 70.3 ± 16. 1 mL), the difference was statistically significant (p < 0.05); At 12 months after operation, the elbow flexion range (127.8 ± 5. 9°), forearm pronation (81.2 ± 3. 3°), and forearm supination (84.2 ± 3. 2°) in the external fixation group were significantly improved compared with the internal fixation group (121.6 ± 7. 1°, 73.2 ± 5. 1°, 80.1 ± 5. 4°), the difference was statistically significant (p < 0.05), and the elbow extension range (0.7 ± 7. 8°) in the external fixation group was not significantly different from the internal fixation group (5.9 ± 8. 3°) (p > 0.05); The Mayo score of elbow joint function in the external fixation group (92.0 ± 7. 1) was better than that in the internal fixation group (86.7 ± 9. 8), the difference was statistically significant (p < 0.05); There was no significant difference in osteotomy healing time between external fixation group (6.8 ± 1. 0 months) and internal fixation group (5.8 ± 1. 6 months) (p > 0.05); The overall complication rate of the two groups was significantly higher in the external fixation group (3 (30.0%)) than that in the internal fixation group (5 (41.7%)) (p > 0.05).
CONCLUSION: Both multi-track mini single arm external fixation and plate internal fixation can effectively treat the missed diagnosis of missed Monteggia fracture in children. The former may have more prominent advantages in operative efficiency and postoperative recovery of elbow flexion and forearm rotation.