[蒙特吉亚和蒙特吉亚式伤病]。

Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2025-06-01 Epub Date: 2025-06-04 DOI:10.1055/a-2550-3007
Anna Goth, Alexander Klug, Reinhard Hoffmann
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引用次数: 0

摘要

Monteggia(样)病变是前臂的一种复合损伤,其特征是尺侧近端骨折并伴有尺侧近端关节(PRUG)桡骨头脱位。如果桡骨头和/或冠状骨也有骨折,这些被称为蒙特吉亚样损伤。蒙特吉亚(类)损伤是一种严重的损伤,如果不进行适当的治疗,可能会造成永久性损伤,如持续运动受限、进行性骨关节炎和疼痛。充分的诊断和治疗对于术后满意的结果至关重要。CT三维重建成像是术前诊断和规划的金标准。一般来说,解剖复位结合骨融合术是治疗蒙特吉亚(样)损伤的首选方法。在绝大多数情况下,手术入路可以是背侧的。尺骨骨折的解剖固定是手术成功的关键,通常采用(锁定)钢板内固定。桡骨头和/或冠突的伴发骨折以及韧带损伤需要特别注意,通常也应予以处理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Monteggia and Monteggia-like Injuries].

Monteggia-(like)-lesions are a combination injury of the forearm characterised by a proximal ulnar fracture with concomitant dislocation of the radial head in the proximal radioulnar joint (PRUG). If there are also fractures of the radial head and/or the coronoid, these are referred to as Monteggia-like injuries. Monteggia(-like) injuries are serious lesions which, without adequate treatment, carry a high risk of permanent damage such as persistent movement restrictions, progressive osteoarthritis and pain. Adequate diagnosis and treatment are essential for a satisfactory postoperative outcome. CT imaging with 3D reconstruction is the gold standard for preoperative diagnosis and planning. Generally, anatomical reduction with osteosynthesis is the treatment of choice for Monteggia(-like) injuries. In the vast majority of cases, the surgical approach can be dorsal. Anatomical fixation of the ulnar fracture is crucial for surgical success and is usually achieved using (locking) plate osteosynthesis. Concomitant fractures of the radial head and/or coronoid as well as ligamentous injuries require special attention and should usually also be addressed.

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