Compare Fresh Adult Monteggia Fracture Radial Head Open Reduction And Closed Reduction Postoperative Effects

Objective: Compare the intraoperative and postoperative of radial head withclosed and open reduction,annular ligament repair or reconstruction in the fresh adultMonteggia’s fracture line ulna open reduction and locked plate screw rigid internalfixation. Explore the approach of the radial head in the surgical treatment of fresh adultMonteggia’s fracture.Methods: Look back our hospital from October2005to January2011, in49cases of adult fresh Monteggia’s fracture which meet the inclusioncriteria, the relationship between radial head processing methods andpostoperative forearm functional recovery. Among these Monteggia’s fracture patients,21cases treated with open reduction（treatment group）and28cases treated with closedreduction（control group）, collate the text medical records of them with clinical data,respectively compare operative time, blood loss, fracture healing time, the number ofcomplications and the improved elbow HSS score of the two groups after6months.Results: The operative time, blood loss in the control group are less than thetreatment group（P<0.05）. In fracture healing time, the major complication rate therewas no significant difference（P>0.05）. After6months elbow function assessment usemodified elbow HSS score, the elbow function excellent rate of two groups have nosignificant differences（P>0.05）.Conclusion: In the treatment of adult fresh Monteggia’s fracture, the ulna with openreduction, radial head with closed reduction and open reduction for annular ligamentrepair or reconstruction both can get satisfactory results. We should choose the bestways according to different types and different patients. For Bado sub-type I patients,after the ulnar fracture open reduction and internal fixation, most can be taken to closedreduction; typing for Bado type II, type III patients, after the ulnar fracture openreduction and internal fixation. most can be closed reduction, if the reset is difficult, should be held in open reduction, ligament repair or reconstruction of the line ring. Forthe of Bado sub-type IV patients, most of the required open reduction and internalfixation in the radius and ulna fractures,radial head open reduction, line the annularligament repair or reconstruction.