腕关节侧位X线摄影测量尺月间距评估尺骨长度变异  

Measurement of nulnolunate distance on the lateral wrist radiograph to evaluate ulnar variance

作　　者：周荣花 詹惠荔 杨勇[2] 王志新[2] 王扬[2] 黄行健[2] 程晓光[1] ZHOU Ronghua;ZHAN Huili;YANG Yong;WANG Zhixin;WANG Yang;HUANG Xingjian;CHENG Xiaoguang(Department of Radiology,Beijing Jishuitan Hospital,Beijing 100035,China;Department of Hand Surgery,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院放射科,北京100035 [2]北京积水潭医院手外科,北京100035

出　　处：《医学影像学杂志》2023年第6期1070-1073,共4页Journal of Medical Imaging

基　　金：北京市医院管理中心临床医学发展专项基金项目(编号:ZYLX202107);北京市卫生系统高层次卫生技术人才培养计划项目(编号:2015-3-036)。

摘　　要：目的探讨测量腕关节侧位X线摄影尺月间距,确定是否存在尺骨变异,并为确诊尺腕撞击综合征和判断手术预后提供依据。方法选取患者年龄18~70岁,共82例标准体位腕关节X线摄影片。分别测量后前位桡尺间距和侧位尺月间距。依据后前位测量结果将患者分为三组:1)尺骨中性变异组(-1mm≤桡尺间距≤1mm)27例;2)尺骨正向变异组(桡尺间距>1mm)37例;3)尺骨负向变异组(桡尺间距<-1mm)18例。分别测量每组病例腕关节侧位片中尺骨头最远端平面和月骨最近端平面间距,并进行统计学分析。结果尺骨中性变异组尺月间距0.00~1.60 mm,平均(0.68±0.44)mm;尺骨正向变异组尺月间距0.30~4.40 mm,平均(1.93±1.06)mm;尺骨负向变异组尺月间距-3.80~-0.70 mm,平均(-2.19±0.98)mm。三者间比较差异有统计学意义(F=131.63,P<0.001)。结论腕关节侧位X线摄影片中尺月间距能准确判断尺骨变异,可以为尺腕撞击综合征诊断和尺骨短缩长度提供有效依据。Objective To determine whether there is ulnar variance by measuring the ulnolunate distance on lateral wrist radiographs,and to provide a basis for the diagnosis of ulnocarpal impaction syndrome and the prognosis of surgery.Methods 82 patients aged 18~70 years were selected and their standard wrist radiographs were studied.The radioulnar distance on posteroanterior(PA)radiographs and the ulnolunate distance on lateral radiographs were measured,respectively.According to the PA measurements,the patients were divided into three groups:27 patients with neutral ulnar variance(-1mm≤radioulnar distance≤1mm),37 with positive ulnar variance(radioulnar distance>1mm),and 18 with negative ulnar variance(radioulnar distance<-1mm).The distance between the most distant plane of the ulnar head and the most proximal plane of the lunate on the lateral wrist radiographs of each group was measured and statistically analyzed.Results In the neutral ulnar variance group,the ulnolunate distance was 0.00~1.60 mm,and the average(0.68±0.44)mm.In the positive ulnar variance group,the ulnolunate distance was 0.30~4.40 mm,and the average(1.93±1.06)mm.In the negative ulnar variance group,the ulnolunate distance was-3.80~-0.70 mm,and the average(-2.19±0.98)mm.There was a statistically significant difference between the three groups(F=131.63,P<0.001).Conclusion The ulnolunate distance measured on lateral wrist radiographs can accurately determine ulnar variation,which can provide an effective basis for the diagnosis of ulnar impaction syndrome and the estimation of ulnar shortening length.

关 键 词：腕关节 尺骨变异 X线摄影 

分 类 号：R681.7[医药卫生—骨科学] R814[医药卫生—外科学]