彩色多普勒超声在小儿桡骨头半脱位的诊断与治疗中的应用价值  

Application Value of Color Doppler Ultrasound in Diagnosis and Treatment of Radial Head Subluxation in Children

作　　者：姚丹[1] 胡苑涛 吴锐坚 YAO Dan;HU Yuan-tao;WU Rui-jian(Department of Ultrasound,Chenghai District People’s Hospital,Shantou City,Guangdong Province,Guangdong Shantou 515800;Department of Orthopedics,Chenghai District People’s Hospital,Shantou City,Guangdong Province,Guangdong Shantou 515800)

机构地区：[1]广东省汕头市澄海区人民医院超声科,广东汕头515800 [2]广东省汕头市澄海区人民医院骨伤科,广东汕头515800

出　　处：《中国医疗器械信息》2023年第8期10-13,共4页China Medical Device Information

摘　　要：目的:探究和分析彩色多普勒超声检查在小儿桡骨头半脱位诊断治疗中的应用价值。方法:回顾性分析2019年5月~2021年5月本院收治的50例桡骨头半脱位患儿的临床及超声影像检查资料。所有患儿均进行常规双侧(患侧和健侧)彩色多普勒超声检查,观察声像图的表现,比较复位前后肘关节屈伸度和前后臂活动度以及一次性复位成功率。结果:桡骨头半脱位的超声表现:50例桡骨头半脱位患儿患侧与健侧声像图表现为肱桡间距增宽46例(46/50,92.00%),关节间隙增强且回声增强42例(42/50,84.00%),旋后肌上移且呈“钩”型表现48例(48/50,95.00%),环状韧带嵌顿47例(47/50,94.00%)。肘前区桡侧纵切面显示桡骨小头相对肱骨小头有移位者50例(50/50,100.00%);肘前区横切面13例(13/50,26.00%);肘外侧区纵切面41例(41/50,82.00%);肘后区纵切面均未检出。另外,患侧肘关节外侧区纵切面显示低回声的液性暗区,高回声的脂肪垫被挤压移位到前方,提示有关节腔积液(6例)。50例患儿中,患侧高频超声多切面扫查较健侧均发现桡骨小头相对肱骨小头位置关系明显异常,均未发现环状韧带撕裂,其中肘前区桡侧纵切面及外侧纵切面检出率最高,分别为100.00%、82.00%。复位后肘关节伸直、屈曲活动度以及前臂旋前、旋后活动度显著高于复位前(P<0.05)。其中2例患儿在第一次复位时拒绝活动上肢(彩色多普勒超声已排除肘关节感染或隐匿性骨折),并于1天后门诊随访,上肢活动均无明显受限。1周后所有患儿于门诊随访,上肢活动无明显受限。彩色多普勒超声检查均可见强回声样组织嵌插于肱桡关节间隙,经手法复位后嵌插组织均消失,显示彩色多普勒超声对桡骨头半脱位诊断的符合率达到100%。结论:通过彩色多普勒超声扫查双侧肘关节,分析声像图的特征,对小儿桡骨头半脱位能够快速准确地做出判断,在桡骨半脱位的诊断�Objective:To explore and analyze the application value of color Doppler ultrasonography in the diagnosis and treatment of radial head subluxation in children.Methods:The clinical and ultrasonic imaging data of 50 children with radial head subluxation admitted to our hospital from May 2019 to May 2021 were retrospectively analyzed.All patients underwent conventional bilateral(affected and healthy)color Doppler ultrasonography to observe the sonographic performance,and compare the flexion and extension of the elbow joint before and after reduction,the range of motion of the front and back arm,and the success rate of one-time reduction.Results:The ul-trasonic manifestations of radial subluxation were as follows:in 50 children with radial subluxation,the ultrasonographic manifestations of affected and healthy sides included:brachioradialis spacing was widened in 46 cases(46/50,92.00%),joint space was enhanced and echo was enhanced in 42 cases(42/50,84.00%),supination muscle was moved up and presented“hook”type in 48 cases(48/50,95.00%),and annular ligament incarcer-ation in 47 cases(47/50,94.00%).Radial longitudinal section of the anterior elbow region showed displacement of the radial head relative to the humeral head in 50 cases(50/50,100.00%).Transverse section of anterior elbow area in 13 cases(13/50,26.00%);Longitudinal section of lateral area of elbow in 41 cases(41/50,82.00%);The longitudinal section of the posterior elbow area was not detected.In addition,the longitudinal section of the lateral region of the affected elbow showed hypoechoic fluid dark area,and the fatty pad with high echoic was squeezed and displaced anteriorly,suggesting a luminal effusion(6 cases).In 50 cases,the position of the radial head to the humeral head on the affected side was significantly abnormal compared with that on the healthy side,and no annular ligament tear was found.The detection rates of radial longitudinal section and lateral longitudinal section in the anterior elbow region were the highest,100.00%and 82.00%,respect

关 键 词：桡骨头半脱位 彩色多普勒超声 诊断显像 

分 类 号：R684.7[医药卫生—骨科学] R445.1[医药卫生—外科学]