[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).

CONCLUSION

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.