关节造影在儿童JacobⅠ型肱骨外髁骨折的应用  

Application of arthrography in treatment of Jacob typeⅠhumeral condyle fractures in children

作　　者：刘连涛 戎帅 李浩 甄可培 周晓彬[1] 李锋[1] 冯建书[1] 李克伟[1] LIU Liantao;RONG Shuai;LI Hao(The Third Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第三医院,050011

出　　处：《河北医药》2022年第21期3292-3295,共4页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展计划项目(编号:181201133)。

摘　　要：目的通过关节造影技术评估JacobⅠ型肱骨外髁骨折的稳定性,指导选择有效的治疗方案。方法回顾性分析2017年1月至2018年4月收治的JacobⅠ型肱骨外髁骨折患者40例,根据关节造影结果分为3组,A组:骨折线从干骺端延伸至骺板,未通过关节面,软骨铰链存在;B组:骨折线从干骺端穿过骺板并通过关节面,软骨铰链不存在,关节面平整;C组:骨折线从干骺端穿过骺板并通过关节面,软骨铰链不存在,关节面不平整。分析3组骨折移位情况,依据Dhillon评分评估患儿肘关节功能情况。结果A组中1例发生位移,移位率为4.76%;B组中3例骨折发生移位,移位率为30.00%;C组中4例骨折发生移位,移位率为44.44%。B、C组软骨铰链破坏,经非手术治疗后骨折移位率明显高于A组(P<0.05),而B组和C组的骨折移位率差异无统计学意义(P>0.05)。A、B、C组评分占优率分别为95.23%、70.00%和22.22%,且B、C组Dhillon评分占优率明显低于A组(P<0.05);而B组Dhillon评分占优率明显高于C组(P<0.05);软骨铰链破坏的JacobⅠ型肱骨外髁骨折经保守治疗后出现二次移位的风险显著增高,肘关节Dillon评分占优率明显减低。结论关节造影能够清晰显示肱骨远端软骨铰链的完整性,充分评估JacobⅠ型肱骨外髁骨折的稳定性,避免X射线等技术的不利因素,提高治疗的成功率,为JacobⅠ型肱骨外髁骨折的临床治疗提供依据。Objective To investigate the effects of arthrography in evaluating the stability of Jacob type I humeral condyle fractures,and to guide the choice of effective treatment scheme.Methods A total of 40 patients with Jacob type I lateral humeral condyle fractures who were treated in our hospital from January 2017 to April 2018 were enrolled in the study,who were divided into three groups according to the examination results of arthrography,group A;fracture line extended from lateral metaphysis to growth plate,without to articular face,with cartilage hinge,and group B:the fracture line extended from lateral metaphysis to growth and to articular face,without cartilage hinge,with even articular surface,and gourp C:the fracture line extended from metaphysis to articular face,without cartilage hinge and even articular surface.The fracture displacement status in the three groups was analyzed,and the elbow joint function was evaluated according to the Dhillon score.Results One patient in group A had displacement,with displacement rate being 4.76%,and 3 patients in group B had displacement,with displacement rate being 30.00%,and 4 patients had fracture,with displacement rate being 44.44%.After non-surgical treatment,the cartilage hinge was destroyed in group B and C,and the fracture displacement rate was significantly than that in group A(P<0.05).There was no significant difference in fracture displacement rate between group B and group C(P>0.05).The ascendant rate of Dhillon score at groups A,B and C was 95.23%,70.00%and 22.22%,respectively,which in group B and group C was significanly lower than that in groups A(P<0.05).However the scores of Dhillon in group B were significantly higher than those in group C(P<0.05).The risk of secondary displacement after conservative treatment in Jacob type I humeral lateral condyle fracture with cartilage hinge damage was significantly increased,and the Dillon score dominant rate of elbow joint was significantly decreased.Conclusion Arthrography can clearly show the integrity of the dist

关 键 词：关节造影 肱骨外髁骨折 儿童 

分 类 号：R683.41[医药卫生—骨科学]