20°上臂倾斜位摄片法在肱骨外髁骨折中的应用价值

Application value of 20 degree upper arm tilt position photography in the treatment of humeral lateral condylar fractures

目的浅析20°上臂倾斜位摄片法在肱骨外髁骨折中的应用价值。方法选取2022年6月至2023年5月江西省儿童医院收治的50例肱骨外髁骨折患儿作为研究对象,所有患儿均采用传统正位与20°上臂倾斜位摄片法,手术结果作为金标准。并根据Jakob分类法进行二次评估,测量不同体位X线正位平片中骨块内侧与外侧的移位距离。结果50例肱骨外髁骨折患儿中,标准位摄片法的Jakob分型为:Ⅰ度29例、Ⅱ度17例、Ⅲ度4例;20°上臂倾斜位摄片法的Jakob分型为:Ⅰ度19例、Ⅱ度27例、Ⅲ度4例。经过测量可知,20°上臂倾斜位摄片法的异位距离大于标准位摄片法,差异有统计学意义(P<0.05)。20°上臂倾斜位摄片法准确率高于标准位摄片法,差异有统计学意义(P<0.05)。50例肱骨外髁骨折患儿中,手术结果为金标准,45例结果正确,5例结果错误;20°上臂倾斜位摄片法灵敏度为97.73%、特异度为66.67%、准确度为94.00%。结论在肱骨外髁骨折中采用20°上臂倾斜位摄片法,能够快速显示患儿肱骨外髁骨折的骨块移位程度,提高诊断的准确率,为临床治疗提供有利的参考依据。

Objective To analyze the application value of the 20 degree upper arm tilt position photography method in the treatment of humeral lateral condylar fractures.Methods A total of 50 children with humeral epicondylar fractures admitted to Jiangxi Provincial Children's Hospital from June 2022 to May 2023 were selected as the study subjects,all of whom were photographed using traditional orthopedic and 20 degree upper arm tilt positions.Surgical results were taken as the gold standard.According to the Jakob classification method,a secondary evaluation was conducted to measure the displacement distance between the inner and outer sides of the bone blocks in the X-ray plain films of different postures.Results Among the 50 children with humeral epicondylar fractures,after two types of photography,in 50 children with lateral condyle fracture,the Jakob classification of standard photography was 29 with degreeⅠ,17 with degreeⅡ,and 4 with degreeⅢ,and Jakob classification of 20 degree upper arm tilt position photography method was 19 with degreeⅠ,27 with degreeⅡ,and 4 with degreeⅢ.After measurement,it could be seen that the ectopic distance obtained by the 20 degree upper arm tilt position photography method was greater than that obtained by the standard position method,and the difference was statistically significant(P<0.05).The accuracy of the 20 degree upper arm tilt position photography method was higher than that of the standard position photography method,with statistical significance(P<0.05).Among the 50 children with humeral epicondyle fracture,the surgical results were the gold standard,45 cases had correct results and 5 had wrong results,and the sensitivity of the 20 degree upper arm tilt position photography method was 97.73%,the specificity was 66.67%and the accuracy was 94.00%.Conclusion Using the 20 degree upper arm tilt position photography method in the diagnosis of humeral epicondylar fractures can quickly display the degree of bone block displacement in pediatric patients,improve the accuracy of diagnosis,and provide favorable reference basis for clinical treatment.