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例1,女,9岁,左肘部摔伤6h来院,检查:左前臂及肘部软组织肿胀,尺侧压疼,畸形,肘关节活动受限;X线片示左尺骨上1/3骨折,桡骨头向前脱位;诊断为孟氏骨折伸直型,手法整复失败行手术治疗,术中见桡骨头呈半球形,发育不良,术中拍对侧X线片示桡骨头脱位,诊断为先天性桡骨头脱位,尺骨上1/3骨折,行尺骨钢板内固定。 例2,女,10岁,右肘部摔伤10h入院,检查,右前臂近端轻度肿胀及压疼,肘关节屈曲130°、伸0°、X线片示右尺骨凸向前,桡骨头向前脱位;诊断为孟氏骨折伸直型,行手法整复,复位失败收住院,拟切开复位,但查体发现右肘及前臂疼痛,肿胀不明显,且左侧肘关节屈曲与患侧基本一致,右肘部X线片发现有桡骨头向前脱位,尺骨凸向前,诊断为双侧桡骨头先天性脱位,未给予治疗。
Case 1, female, 9 years old, left elbow fell 6h to hospital, check: the left forearm and elbow soft tissue swelling, ulnar pressure pain, deformity, elbow motion restriction; X-ray showed the left ulna on the 1/3 fracture , The radial head forward dislocation; diagnosis of Monteggia fracture straight type, manipulation of the failure to complete the operation of surgery, see the radial hemispherical surgery was intraoperative, hypoplasia, intraoperative radiographs showed contralateral radial head dislocation, the diagnosis Congenital radial head dislocation, the ulna on the 1/3 fracture, line ulna plate fixation. Case 2, female, 10 years old, right elbow fell 10h admission, examination, mild swelling and tenderness of the proximal right forearm, elbow flexion of 130 °, 0 ° extension, X-ray showed the right ulnar convex forward, radial head Forward dislocation; diagnosis of Monteggia fracture straight type, the line of plastic surgery, failed to reset the hospital, intended to open reduction, but the examination found that the right elbow and forearm pain, swelling is not obvious, and the left elbow flexion and suffering Side of the same, the right elbow X-ray showed radial head forward dislocation, ulnar convex forward, the diagnosis of bilateral radial head congenital dislocation, no treatment.