高频超声诊断足踝部微小骨折

High frequency ultrasound diagnosis of little bone fracture of ankle

目的探讨高频超声诊断足踝部微小骨折的临床价值。方法对37例首诊X线阴性而高频超声提示微小骨折的患者再行针对性的X线检查,对针对性X线检查阴性病例再行CT和(或)MR检查,统计针对性X线检查的结果,并分析微小骨折的超声声像图特征。结果①损伤部位:腓骨(外踝部)16例、胫骨(内踝部)12例、距骨(颈部)2例、舟骨4例、蹠骨2例、跟骨1例。②针对性X线检查检出26例阳性(26/37,70.27%),检出率较常规X线检查明显提高。③高频超声微小骨折声像图表现:局部骨组织不完整(表面不光滑),骨折周软组织肿胀增厚,骨组织无错位。结论高频超声诊断微小骨折可作为X线检查的补充,为临床治疗提供较全面的依据,具有重要的临床价值。

Objective To assess the clinical value of high frequency ultrasound diagnosis for little bone fracture of ankle.Methods Thirty-seven ankle wound patients with negative X-ray examination underwent high frequency ultrasound.The second X-ray examination was performed on patients with hinted little bone fracture of ankle,and then CT/MR examination was performed on patients whose second X-ray examination was negative.The consequence of the second X-ray examination was counted and the sonographic features were analyzed.Results ①Little fracture of fibula（lateral malleolus）was in 16,of tibia（medial malleolus）in 12,of talus in 2,of scaphoid bone in 4,of metatarsale in 2 and of calcaneus in one patients.②The second X-ray examination was positive in 26 patients（26/37,70.27%）,indicating that the detection rate of the second X-ray is higher than that of the first X-ray.③Sonographic features of little bone fracture of ankle included incomplete bone surface of bone was rough and soft tissue swelling and thickening.No malposition of bone fracture was found.Conclusion High frequency ultrasound is supplementary for X-ray examination,being able to possess important clinical priority in the diagnosis of little bone fracture.