Objective: To analysis the treatment effect of the ulnar osteotomy and ring-shaped ligament reconstruction for the treatment of old Monteggia fracture in children by using Meta analyze, and the difference of clinical curative effect was compared in order to provide the basis for the selection of clinical treatment options for old Monteggia fractures in children. Methods: We searched databases such as CNKI, Wanfang database, Medline, PubMed, Embase and Science through computer, at the same time, the references of relevant documents were retrieved manually, and the data processing was carried out by the RevMan5.3 statistical software provided by the Cochrane cooperation network by incorporating the exclusion criteria. The results were obtained and analyzed. Results: A total of 17 standard literature, 438 cases, 224 cases of ulnar osteotomy, 214 cases with ring ligament repair and reconstruction were obtained. The operation scheme, which was mainly based on the lengthening of ulna osteotomy, was superior to the reconstruction of ring ligament reconstruction. The complications and second operation rates of the former was less than that of the latter. Conclusion: The surgical methods for the reconstruction of the ulna osteotomy and the ring-shaped ligament have advantages and disadvantages. The choice of the operative plan for the old Monteggia fracture should be based on the following factors: the time of the old Monteggia fracture formation, the degree of the ulnar and radial deformity and the familiarity of the operative method.
目的: 对尺骨截骨延长术及环状韧带重建术为主的手术方法治疗儿童陈旧孟氏骨折治疗效果进行荟萃分析,比较其临床疗效的差异,以期为儿童陈旧孟氏骨折临床治疗方案选择提供依据。 方法: 通过计算机检索CNKI、万方数据库,同时手工检索相关文献的参考文献,通过纳入排除标准筛选,以Cochrane协作网提供的RevMan 5.3统计软件进行数据处理。文献检索以"孟氏骨折","陈旧","小儿"为关键词,通过上述数据检索共获得346篇文章,符合纳入标准文献14篇,438例。以"Old Monteggia fracture in children 、neglected Monteggia fracture"检索Medline(1966年1月—2017年5月)、PubMed(1980年1月—2017年5月)、Embase(1990年1月—2017年5月)、Science(1990年1月—2017年5月)数据库共获得61篇,符合标准外文文献3篇,并对其进行分析。 结果: 共获得符合纳入标准文献17篇,共438例,尺骨截骨延长为主要手术方式的病例(延长组)224例,以环状韧带修复重建为主的病例(重建组)214例,重建组34例出现术后并发症(复发性桡骨小头脱位、关节僵硬),延长组共21例出现并发症(尺骨畸形、不愈合,神经损伤、骨筋膜室综合征)。在术后优良率方面以尺骨截骨延长为主的手术方案优于环状韧带重建为主的手术方案,并发症及2次手术率方法前者少于后者。 结论: 以尺骨截骨与环状韧带重建为主的手术方式各有利弊,陈旧孟氏骨折的手术方案选择应依据下述因素:陈旧孟氏骨折形成时间、尺桡骨畸形的程度、肘关节的外观及功能状态。.
Keywords: Monteggia fracture; Old; Pediatric; Surgery Meta analysis.