青少年第五跖骨近端骨骺与骨折的数字X线摄影特点探讨及临床意义  

Clinical significance of the DR characteristics of juvenile proximal fifth metatarsal fracture of epiphysis

作　　者：刘建立[1] 刘吉华[1] 来洪建[2] 张兴安[3] 

机构地区：[1]青岛大学医学院附属医院放射科,266003 [2]山东菏泽市立医院CT室 [3]山东兖州市人民医院放射科

出　　处：《实用医学影像杂志》2015年第5期409-411,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨青少年第五跖骨近端骨骺形态特点及近端骨折的X特征。方法回顾性分析了1421名（其中男性836名，女性585名）6～15岁健康青少年（除外近期外伤）足部斜位片第五跖骨近端骨骺的出现率、形态特点及其走行，并对比观察了44例第五跖骨近端骨折特点。结果285例（20．1％）青少年出现骨骺，形态各异，分别为粟粒状41例（14．5％），鱼鳞片状217例（76．2％），卵圆形10例（3．4％），不规则状17例（5．9％），其中8．3％的骨骺多发不连续，形态遵循骨骺发育规律。骺线多与骨干相平行，少数呈斜形或横行。44例第五跖骨近端骨折，包括1型粗隆尖部骨折15例（34．1％），2型斜形骨折6例（13．5％），3型横行骨折23例（52．4％）；骨折块形态多不规则，骨折线锐利，常为横行，骨折与其周围解剖结构特殊性及受伤机制有关。结论青少年第五跖骨近端骨骺及骨折形态多样，各具特点，正确认识对提高诊断符合率尤为重要。Objective To investigate the juvenile fifth metatarsal proximal epiphysis morphology and fracture of the proximal X characteristics. Methods A retrospective analysis of 1 421 cases （ 836 males;585 females） normal adolescents aged 6-15 years （except trauma recently）, foot inclined piece fifth metatarsal proximal epiphysis rate, mor- phological characteristics and out of shape, and the comparative observation of 44 cases of the fifth metatarsal frac- tures of the proximal. Results Two hundred and eighty-five cases （20.1%） adolescents appeared epiphysis, shapes, respectively, miliary in 41 cases （14.5%）, 217 cases of fish flake （76.2%）, 10 cases of oval （3.4%）, irregular shape in 17 cases （5.9%）, of which 8.3% of the epiphysis multiple discontinuous, form follows the epiphysis growth law. The epiphysis line was parallel with the backbone in the majority, the minority was oblique or transverse. Forty-four cases of the fifth metatarsal fractures of the proximal, including type 1 tuberosity tip fracture in 15 cases （34.1%）, 2 type of oblique fracture in 6 cases （13.5%）, type 3 transverse fractures in 23 cases （52.4%）; fracture blocks were irregular in shape, the fracture line sharp, often run amok, fractures and surrounding anatomic particularity the structure and the mechanism of injury related. Conclusion Adolescent fifth metatarsal fractures proximal epiphysis and morphological diversity, each with its own characteristics, the correct understanding to improve the diagnosis rate is particularly important.

关 键 词：青少年 跖骨 骨骺 骨折 放射摄影术 

分 类 号：R726.8[医药卫生—儿科] R816.92[医药卫生—临床医学]