儿童肘关节轻微骨折X线平片分析

X-ray Finding Analysis in Children with Slight Elbow Fracture

目的提高X线平片对儿童肘关节轻微骨折的诊断准确率。方法选取我院2006—2009年儿童肘关节轻微骨折X线片63例,对X线片的特征进行回顾性分析。结果青枝型肱骨髁上骨折26例;无移位的肱骨外髁骺板骨折19例;尺骨鹰嘴背侧骨折6例;桡骨颈骨折6例;尺骨冠状突骨折3例;未见骨折征象仅见软组织明显肿胀伴肘部脂肪垫征阳性,于20 d后复查时发现肱骨远端骨痂形成2例;肱骨滑车骨骺分离1例。结论儿童肘关节轻微骨折以青枝型肱骨髁上骨折及肱骨外髁骺板骨折多见,无移位的肱骨外髁骺板骨折最容易漏诊,软组织严重肿胀及脂肪垫征阳性提示可能存在隐匿性骨折。熟悉儿童轻微骨折的常见部位及X线征象,仔细观察可以有效避免漏诊。

Objective To improve diagnostic accuracy of X - ray film in children with slight elbow fracture. Methods The X - ray films of 63 children with slight elbow firacture from our hospital from 2006 to 2009 were analyzed retrospectively. Results Twenty -six patients presented with willow humeral supracondylar fracture, 19 with undisplaced humerus lateral condyle epiphyseal plate fracture, 2 only with soft tissue swelling with positive elbow fat pad sign but without fracture signs and distal humerus callus formation was seen in follow up after 20 d, 1 with humeral trochlea epiphyseal separation, 6 with dorsal olecranon fracture, 6 with radial fracture, 3 with ulna coronoid process fracture. Conclusion Slight elbow fractures in children are mainly willow humeral supracondylar fracture and humerus lateral condyle epiphyseal plate fracture, and un - displaced humerus lateral condyle epiphyseal plate fracture is easy to be misdiagnosed. Soft tissue swelling and positive elbow fat pad sign may suggest occult fracture. Understanding the common sites of slight fractures in children and X - ray findings can avoid missed diagnoses.