儿童肘关节常见骨折的DR诊断体会  

Diagnosis of Common Elbow Fracture in Children by DR

作　　者：詹青霞[1] 武刚[1] 蒋黛蒂[1] 王佩芬[2] 

机构地区：[1]复旦大学附属中山医院青浦分院放射科 [2]复旦大学附属中山医院放射科

出　　处：《中国医学计算机成像杂志》2012年第6期522-524,共3页Chinese Computed Medical Imaging

摘　　要：目的:总结儿童肘关节常见骨折DR片的诊断经验。方法:有确切肘关节外伤史伴肿胀且DR诊断为3种常见骨折的患儿114例。其中肱骨髁上骨折81例,外侧髁骨折20例,内侧髁上骨折13例。观察明确显示的骨折线、肱骨前线征、肱桡小头线征、骨化中心位置和排列顺序及有无前后脂肪垫征、泪滴变形。结果:肱骨髁上骨折中明确显示骨折线比例为97.5%,肱骨前线征为92.6%,泪滴变形为81.5%,前后脂肪垫征为21%;外侧髁骨折中明确显示骨折线比例为85%,肱桡小头线征为65%,骨化中心位置和排列顺序改变为25%,前后脂肪垫征为20%;内侧髁上骨折中骨化中心位置和排列顺序改变比例为76.9%,明确显示骨折线为23.1%,前后脂肪垫征为15.4%。结论:诊断肱骨髁上骨折和外侧髁骨折主要依靠直接显示的骨折线,诊断内上髁骨折主要依靠肘部骨化中心位置和排列顺序的改变,肱骨前线征、泪滴变形、肱桡小头线征、脂肪垫征都是十分重要的辅助诊断征象。Purpose： To summarize the DR diagnostic experiences of common elbow fracture in children. Methods： One hundred and fourteen children with 3 kinds of common elbow fractures confirmed by DR were enrolled in our study. All the cases were with clear history of trauma. The fractures included 81 cases of supracondylar fracture of the humerus, 20 cases of lateral condylar fracture, 13 cases of medical supracondylar fracture. The features of all cases of the fractures, which included： the fracture line, the anterior humeral line sign, radiocapitellar line, change of site of ossification center with arrangement orders, anterior, and posterior fat pad signs, radiographic teardrops were observed. Results： For the supracondylar fracture of the humerus, the display rate of significant fracture lines was 97.5%, of the anterior humeral line sign was 92.6%, of the radiographic teardrop was 81.5%, of far radiocapitellar line sign was 65%, of change of site of ossification center with arrangement orders was 25%, of anterior and posterior fat pad signs was 20%. For the medical supracondylar fracture, the display rate of change of site of ossification center with arrangement orders was 76.9%, of the significant fracture line was 23.1%, of demonstration of anterior and posterior fat pad signs was 15.4%. Conclusion： Diagnosis of supracondylar fracture of the humerus and lateral condylar fracture relies majorly on demonstration of direct fracture lines, for the medical supracondylar fracture would be the demonstration of the change of the elbow ossified centre site and arrangement order. The anterior humeral line sign, radiographic teardrop, radiocapitellar line, and posterior or anterior fat pad sign are the most crucial signs for their diagnosis.

关 键 词：儿童 肘关节 骨折 DR 

分 类 号：R726.8[医药卫生—儿科]