요골골두 탈구의 정복은 척골골절 관혈적 정복에 겸하여 요골골두 관혈적 정복을 시행한 예는 7례 였으며, 소아의 경우 3례에서 관혈적 정복술이 필요하였다. 총 63례중 45례에서 도수정복으로 요골골두 탈구의 정복을 시행하였으며, 성인 6례에서 요골골두 제거술을 시행하였다.
9. 6개월이상 추시관찰이 가능하였던 소아 14례중 13례(93%)에서, 성인 28례중 20례(71%)에서 Bruce방법에 의하여 치료성적을 검토한후, 만족스러운 결과를 얻었다.
Clinical study on Monteggia fracture
Chong Hyuk Choi
Department of Medical Science, The graduate School, Yonsei University
(Directed by Professor Eung Shick Kang, M.D.)
Monteggia fracture-dislocation was described as a fracture of proximal one third
of the ulnar with a dislocation of radial head by G.B. Monteggia in 1814. Bado
named Monteggia lesion as a fracture of ulnar at any level and a dislocation of
radial head.
The author reviewed sixty-three patients of Monteggia fracture who were treated
at Department of Orthopedic Surgery, Yonsei University College of Medicine form
1980.1. to 1985.12. The study was emphasized especially on cause of injury,
fracture classification, direction of radial head dislocation, level of ulnar
fracture site, treatment and results.
The result were as follows:
1. There were 22 children and 41 adults among 63 patients.
2. The male was affected more frequently that female (49:14).
The ratio between male and female was 3.5:1.
3. The most common cause of injury was falling down (54%) in children and car
accident (51%) in adult.
4. According to Bado classification type Ⅰ was 68%, type Ⅱ 11%, type Ⅲ 18% and
type Ⅳ 3%.
5. The partial posterior interosseous nerve injury was noticed in 11 cases and
the superficial radial sensory nerve injury was in 3 cases. The nerve injury was
recovered spontaneously in all cases.
6. Dislocation of radial head was as follows: Anterior dislocation was 38%,
anterolateral 41%, lateral 8%, posterior 10% and posterolateral 3%.
7. Location of ulnar fracture site was as follows: Metaphysis 22%. upper 1/3 24%,
junction of upper and mid 1/3 38%, middle 1/3 14% and lower 1/3 2%.
8. Closed reduction of radial head dislocation was done in 45 cases, open
reduction in 10 cases and radial head excision in 6 cases.
9. Closed reduction of ulnar fracture was done in 26 cases and open reduction in
35 cases.
10. The follow-up period was between 6 months and 5 years.
The results were excellent in 18 cases, good in 15 cases, fair in 4 cases and
poor in 5 cases.
[영문]
Monteggia fracture-dislocation was described as a fracture of proximal one third of the ulnar with a dislocation of radial head by G.B. Monteggia in 1814. Bado named Monteggia lesion as a fracture of ulnar at any level and a dislocation of radial head.
The author reviewed sixty-three patients of Monteggia fracture who were treated at Department of Orthopedic Surgery, Yonsei University College of Medicine form 1980.1. to 1985.12. The study was emphasized especially on cause of injury, fracture classification, direction of radial head dislocation, level of ulnar fracture site, treatment and results.
The result were as follows:
1. There were 22 children and 41 adults among 63 patients.
2. The male was affected more frequently that female (49:14).
The ratio between male and female was 3.5:1.
3. The most common cause of injury was falling down (54%) in children and car accident (51%) in adult.
4. According to Bado classification type Ⅰ was 68%, type Ⅱ 11%, type Ⅲ 18% and type Ⅳ 3%.
5. The partial posterior interosseous nerve injury was noticed in 11 cases and the superficial radial sensory nerve injury was in 3 cases. The nerve injury was recovered spontaneously in all cases.
6. Dislocation of radial head was as follows: Anterior dislocation was 38%, anterolateral 41%, lateral 8%, posterior 10% and posterolateral 3%.
7. Location of ulnar fracture site was as follows: Metaphysis 22%. upper 1/3 24%, junction of upper and mid 1/3 38%, middle 1/3 14% and lower 1/3 2%.
8. Closed reduction of radial head dislocation was done in 45 cases, open reduction in 10 cases and radial head excision in 6 cases.
9. Closed reduction of ulnar fracture was done in 26 cases and open reduction in 35 cases.
10. The follow-up period was between 6 months and 5 years.
The results were excellent in 18 cases, good in 15 cases, fair in 4 cases and poor in 5 cases.