一滴水 发表于 2012-4-23 12:15:55

Monteggia骨折(孟氏骨折)X线片病例点评

1. This 5-year-old boy fell on his outstretched arm and has pain in his elbow. He arrives in a splint and views of the
elbow (first and second images) are given to you. What are the findings on the anteroposterior view of the elbow?
1患儿,男,5岁,跌倒时手臂外伸,肘痛。就诊时,已行夹板固定(如图1、2)。肘关节前后位片有何表现?
2. How does the lateral view of the elbow help you?
2.肘关节侧位片有何价值?

3. What do you ask for next? Why?
3下一步该如何?为什么?

4. What eponym is associated with this injury?
4本病以谁的名字命名?

一滴水 发表于 2012-4-23 12:16:19

Diagnosis: Monteggia Fracture
诊断:Monteggia骨折
1. The elbow looks normal.
1. 肘关节前后位片看起来正常。
2. The anterior dislocation of the radial head is evident only on this view.
2. 桡骨头前脱位仅见于侧位片。
3. Ask for a view of the entire forearm (third image) because radial head dislocation is associated with ulna fracture.
3.加照一前臂片(图3),因为桡骨头脱位与尺骨骨折有关。
4. Giovanni Battista Monteggia (Italian physician and surgeon, 1762 to 1815) described this fracture pattern in 1814.
4. Giovanni Battista Monteggia(意大利内科、外科医生,1762 -1815)于1814年描述此种骨折类型。

Reference参考文献
Johnson KJ, Bache E: Imaging in pediatric skeletal trauma, Berlin-Heidelberg-New York, 2008, Springer, pp 270–272.

Cross-Reference相关参考文献
Blickman JG, Parker BR, Barnes PD: Pediatric radiology—the requisites, ed 3, Philadelphia, 2009, Mosby, pp 194–196.

Comment点评
These fractures occur most frequently in children between 5 and 7 years old. Seventy percent have this pattern, with anterior radial head dislocation and ulna fracture. Lateral dislocation and ulna fracture is the second- most common pattern, with posterior dislocation occurring rarely. It is also unusual to see fracture of both radius and ulna associated with anterior radial head dislocation. Because the forearm fracture is the more obvious injury, it can divert attention from the dislocation that, if untreated, can lead to loss of mobility.
Monteggia骨折常见于5-7岁儿童,70%表现为尺骨骨折并桡骨头前脱位,其次为尺骨骨折并桡骨头外脱位,并桡骨头后脱位者罕见。尺桡骨双骨折并桡骨头前脱位者亦少见。由于前臂骨折更为明显,可能会因此忽视桡骨头脱位。如不治疗,桡骨头脱位可引起关节活动不能。

天高海阔 发表于 2012-4-23 15:38:45

谢谢分享,辛苦了。

dongesheng 发表于 2012-5-6 17:04:36

很精彩,学习啦!

来来往往 发表于 2012-12-9 17:38:01

书上定义为尺骨上三分之一骨折伴桡骨小头脱位,此病例骨折位置略偏下,不知是否还可以称Monteggia骨折

轻云飞扬 发表于 2016-3-25 21:29:13

感谢分享。
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