腕管位在腕骨骨折中的临床应用价值

The Clinical Value of Carpal Tunnel View in Carpal Bones Fracture

目的探讨腕管位在腕骨骨折中的临床应用价值。方法 16例腕骨骨折患者均行常规正侧位及腕管位X线检查(部分患者行螺旋CT扫描及三维重建),比较单纯常规摄片及常规摄片+碗管位在显示骨折方面的差异(检出率、骨折线位置的判定、骨折错位的分辨),根据各检查结果并复习相关文献进行综合分析。结果 16例中,6例为舟状骨骨折,3例为钩骨骨折,5例为豆状骨骨折,2例大多角骨前角骨折,其中10例行CT扫描。16例中单纯的常规摄片组漏诊6例,可疑3例,常规摄片+碗管位对骨折的检出率为100%,常规摄片组有9例对于骨折线位置的判定不准确、骨折错位分辨不清晰,常规摄片+碗管位组则对16例均较全面地显示骨折线位置及骨折错位情况,尤其能清晰显示钩骨钩、大多角骨前角、豆状骨及舟状骨掌侧上部骨折。结论腕管位X线检查作为常规腕关节正侧位的有效补充,能减少钩骨钩、豆状骨、舟状骨掌侧及大多角前角骨折漏诊的几率(特别对钩骨钩及大多角骨前角的骨折),为临床治疗提供更全面、准确的影像学依据。

Objective To discuss the clinical value of carpal tunnel view in diagnosing carpal bones fractures. Meth- ods 16 patients of carpal bones fractures underwent X ray examination include AP, lateral and carpal tunnel view（ Part of the cases were examined with Spiral CT and 3D reconstruction）. The difference of showing the fracture details, including detection rate, position of the fracture line, fracture dislocation, between simple conventional radiograph and conventional radiograph ＋ carpal tunnel view were compared. Results In 16 patients, 6 cases had scaphoid fractures ,3 cases bad hamate fractures, 5 caseshad pisiform bone fractures, 2 eases had anterior horn of trapezium fractures. In 16 cases,6 cases were misdiagnosed and 3 cases were uncertain by means of simple conventional radiograph, all cases were showed fracturesbv means of conventional radiograph ＋ carpal tunnel view. All the position of the fraclure line and resolution of fracture dislocation were showed full.＇,＇ on conventional radiograph ＋ carpal tunnel view,especially fi＇aetures in hamate hook, pisi- form, anterior horn of trapezium and anterior superior scaphoid. Conclusion Carpal tunnel view is an effeelive supple- ment ＇to the conventional wrist joints AP and lateral X ray in diagnosis of carpal bones fractures, especially in displaying fractures tff hamate hook, pisiform, anterior horn of trapezium and anterior superior scaphoid, which provide a more com- prehensive and accurate imaging basis for clinical to treatment.