20度倾斜位摄片法在轻度移位肱骨外髁骨折中的应用  

The application of 20-tilt anteroposterior （A-P） radiography in assessment of mild displaced lateral condylar fracture of distal humerus

作　　者：沈品泉[1] 赵黎[1] 陈珽[1] 

机构地区：[1]上海交通大学医学院附属新华医院儿骨科,上海200092

出　　处：《中华小儿外科杂志》2013年第3期199-201,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨20度倾斜位摄片法在甄别轻度移位儿童肱骨外髁骨折骨块移位程度中的作用。方法连续收集轻度移位肱骨外髁骨折的患儿58例，每个病例均采用传统正位和20度倾斜位摄片。按Finnbogason分类法进行重新评估，并测量不同体位X线正位平片中骨块内侧和外侧的移位距离。结果全部58例中，Finnbogason分类为B型病例较初诊减少12例，C型病例较初诊增加18例，20度倾斜位正位片中骨块内侧和外侧的移位距离分别为（3．8±2．1）mm和（6．4±2．6）mm，而标准平片骨块内侧和外侧的移位距离分别为（1．7±1．1）mm和（2．1±1．6）mm，两种摄片法获得的内、外侧距离的差异均有统计学意义（P〈O．05）。12例患儿经重新评估后改用手术治疗。结论加用20度倾斜位摄片，能更好和快速地显示儿童肱骨外髁骨折的骨块移位程度，为选择正确的治疗方案提供了有力的影像学依据。Objective To investigate the efficacy of 20°-tilt anteroposterior （A-P） radiography in assessment of lateral condylar fractures of distal humerus. Methods A total of 58 children with mild displaced lateral condylar fractures of the distal humerus were recruited in this study. Each child underwent conventional A-P and 20 -tilt radiography before surgery. Fracture type was assessed according to the Finnbogason classification system. Fragment dislocation was measured at lateral and medial margins of fracture on radiographs. Results Of the 58 fractures, the 20 -tilt anteroposterior （A-P） radiography decreased 12 diagnosis of type B fracture and increased 18 diagnosis of type C fracture compared with the conventional radiography. The extent of dislocation at lateral and medial margins of fracture site on 20°-tilt A-P radiography [（3.8 ± 2. 1）mm and （6. 4 ± 2. 6）mm] was significantly wider than that on conventional radiography [（1.7 ± 1.1）turn and （2. 1 ± 1.6）mini. There was significant difference between the 20°-tilt A-P radiography and conventional radiography in determining the extent of displace of fractures （P〈0. 05）. Conclusions The 20°-tilt anteroposterior （A-P） radiography is more precise in assessment of fragment dislocation than conventional radiograph.

关 键 词：肘关节 骨折 放射摄影术 儿童 

分 类 号：R726.8[医药卫生—儿科]