近侧指间关节闭合性掌板损伤超声诊断价值探讨  

Value of ultrasonography in diagnosis of closed volar plate injury of proximal interphalangeal joint

作　　者：郭飞[1,2] 王铁铮[3] 崔丽园 刘丽华 包守刚 牟晓飞 滕剑波 亓恒涛 Guo Fei;Wang Tiezheng;Cui Liyuan;Liu Lihua;Bao Shougang;Mu Xiaofei;Teng Jianbo;Qi Hengtao(Binzhou Medical University,Yantai 264003,China;Department of Ultrasound,Weihai Municipal Hospital,Cheeloo College of Medicine,Shandong University,Weihai 264200,China;Department of Ultrasound,Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]滨州医学院,烟台264003 [2]山东大学附属威海市立医院超声科,264200 [3]山东第一医科大学附属省立医院超声医学科,济南250021

出　　处：《中华超声影像学杂志》2021年第12期1077-1080,共4页Chinese Journal of Ultrasonography

基　　金：山东省重点研发计划(2019GSF108271);山东省自然科学基金(ZR2019PH086)。

摘　　要：目的探讨高频超声在近侧指间关节闭合性掌板损伤中的应用价值。方法对2015年5月至2021年5月于山东第一医科大学附属省立医院手足外科临床证实的41例急性闭合性掌板损伤的患者进行高频超声检查,分析其声像图特征并进行分型。结果41例患者高频超声均可清晰显示掌板厚度、形态及其回声,明确掌板损伤的程度及有无撕脱骨折,可分为A、B、C三型。A型13例:近侧指间关节掌板中节指骨基底附着处撕脱骨折,声像图表现为掌板中节指骨基底附着处连续性中断,掌板远心端可见强回声撕脱骨片;B型11例:掌板中节指骨基底处完全断裂,无撕脱骨折,声像图表现为掌板于中节指骨基底附着处连续性中断,断端挛缩增粗;C型17例:掌板撕裂,声像图表现为掌板增厚,内回声不均,部分可见无回声区显示。超声测量三种类型近侧指间关节闭合性掌板损伤的厚度为(0.33±0.05)cm,对侧相应手指相同位置处掌板的厚度为(0.22±0.03)cm,两者之间差异有统计学意义(t=7.864,P=0.006)。结论高频超声是诊断近侧指间关节闭合性掌板损伤首选的影像学检查方法,对于临床治疗方案的选择具有重要的指导意义。Objective To evaluate the role of high frequency ultrasonography in diagnosis of closed volar plate injury of proximal interphalangeal joint.Methods From May 2015 to may 2021,41 patients with acute closed volar plate injury confirmed by Department of Hand and Foot Surgery of the Provincial Hospital Affiliated to Shandong First Medical University were examined by high frequency ultrasonography.The sonographic features were analyzed and classified.Results High frequency ultrasonography could not only clearly show the thickness,shape and echo of volar plate,but also the degree of injury and avulsion fracture of volar plate,according to which the closed volar plate injury could be divided into three types:A,B and C.Type A(13 cases):Avulsion fracture of the middle phalangeal base was found with volar plate rupture,the sonogram showed that the continuity of the volar plate attachment of the middle phalangeal base was interrupted,and avulsion fracture was found at the distal end of the volar plate.Type B(11 cases):Complete rupture of the volar plate attachment of the middle phalangeal base was found without avulsion fracture,the sonogram showed that the continuity of the volar plate attachment of the middle phalangeal base was interrupted,and the end of the volar plate contracted and thickened.Type C(17 cases):Tear of the volar plate was found,the sonogram showed enlarging volar plates,heterogeneous internal echo,and liquid dark area was visible in some cases.The average thickness of the three types of closed volar plate injury of the proximal interphalangeal joint measured by ultrasound was(0.33±0.05)cm,and the average thickness of the volar plate at the same position of the corresponding finger on the opposite side was(0.22±0.03)cm.There was significant difference between the two groups(t=7.864,P=0.006).Conclusions High frequency ultrasonography is the preferred imaging examination method for the diagnosis of closed volar plate injury in proximal interphalangeal joint,which has an important guiding significance for

关 键 词：超声检查 近侧指间关节 掌板 

分 类 号：R658.2[医药卫生—外科学]