Improved Ilizarov External Fixator And Herbal Fumigation Treat The Children’s Old Monteggia Fracture

Objective Observation improved Ilizarov external fixation device minimally invasive surgery combined with local herbal fumigation treatment of children old Monteggia fracture clinical.Methods The retrospective study from 2011 to 2015,Orthopaedic Hospital in Huaxian were treat 40 cases of patients,children aged 3-14 years,the average age of 8.5 years,all cases of fracture type according to Bado’s classification,27 cases of type I,2 cases of type II,11 cases of type III,and all cases containing 4 patients had symptoms of radial nerve injury..Taken in accordance with its method of treating,40 patients were divided into three groups,namely Group A for the traditional ulnar osteotomy fixation surgery,After surgery the patient to cast immobilization for 4-6 weeks to strengthen fixed,after the removal of gypsum gradually elbow flexion,dorsiflexion and forearm pronation and supination function exercise.Group B apply Ilizarov external fixation devices minimally invasive surgery,After surgery performed without plaster immobilization,after 3 days or so can be gradually appropriate for eblow flexion dorsiflexion and forearm pronation and supination function exercise,7 days after surgery,make ulna do longitudinal extension in accordance with the requirements of Ilizarov technique,every time to 0.25 mm,a total of four times a day to 1.0mm,until the humerus and radial distance of 5.0mm,stop doing the longitudinal extension of the ulna.When the humerus and radial distance of 5.0 mm,with matching modified Ilizarov external fixation device does not hinge on the isometric extension to make the cut ends of the two angles to the direction and the radial head dislocation,until the radial head completely reset.Radial head stop not isometric extension after reset,continue with external fixation device fixed until ulna osseous healing(average 3.2 months).Reach the standard osseous healing after demolition of external fixation device.Treatment group C and group B are the same,but after the demolition of external fixation device,such as nail hole closed except for functional exercise,but also to the topical application of Chinese herbal medicine fumigation treatment of elbow to promote the function recovery of elbow joint.Before treatment in the three groups were statistically analyzed clinical data of age,sex,time of injury,fracture type,etc.,the difference was not statistically significant(P> 0.05),were Comparable.Follow-up of 12 months after the function in accordance with the evaluation criteria to understand Mackay excellent rate after treatment and before elbow flexion,dorsiflexion and forearm rotation measurements,supination angle values for statistical analysis.Results ALL cases were followed,the follow-up period was 12-month.All surgical wound healed well,tear down the stitches on time(about 2 weeks),Ulnar fracture healing as expected(average 3.2 months),Radial nerve symptoms were disappear.After 12 months of follow-up.The evaluation criteria based on Mackay function,excellent rate was 94.7% in group C,excellent rate was 91.7% in group B,excellent rate was 77.8% in group A.Three groups were observed in elbow flexion、dorsiflexion and pronation、supination function improved after surgery compared to it of Without surgery.When after the angle is measured,all patients of flexion、dorsiflexion and pronation、pination of the previous surgery and 12 months after surgery,compare to it by statistical analysis.The 3 set of data Before surgery has no significant difference between groups(P> 0.05);Dorsiflexion angle between the groups,but after 12 months measured and elbow flexion;3 patients after 12 months of follow-up data were measured before surgery and in the control group improved significantly,the difference was statistically significant(P <0.05);There was no difference objection.And in front of forearm pronation,supination angle C group situation than the other two groups significantly improved by statistical analysis of the difference was statistically significant(P <0.05);group B and group A group improved compared to the situation by statistical analysis the difference was not statistically significant(P> 0.05).Conclusion(1)Improved ilizarov external fixation device of minimally invasive surgery and traditional ulnar osteotomy in the treatment of children old Monteggia fractures have a very good effect,worthy of clinical application.(2)Local Chinese medicine fumigation important role as an aid in improving the functional aspects of physical activity.