耻骨支应力性骨折的X线诊断

X-ray diagnosis of stress fracture of the pubic ramus

目的 探讨耻骨支应力性骨折的X线表现及其诊断价值。方法 回顾性分析 6 6例耻骨支应力性骨折的X线表现。男 18例 ,女 48例 ,年龄 18～ 2 1岁。其中 5 5例为参加入伍基础训练的新兵 ,11例为参加高强度正步训练的老兵。结果 单纯耻骨下支骨折 6 2例 ,其中右侧 2 6例、左侧30例、双侧 6例 ,同侧耻骨上下支双骨折 4例。 3例发病 2周内X线检查为阴性 ;6 6例 4周至 8个月X线检查有明显的透亮骨折线 (34例 )或 (和 )致密骨痂 (6 5例 )。结论 X线检查是本病首选的影像手段 ,大多数病例根据X线表现及临床资料可作出正确诊断。

Objective To study the X-ray findings and evaluate the value of X-ray in diagnosis of stress fracture of the pubic ramus. Methods The X-ray findings of 66 cases (18 males and 48 females, ranging in age from 18-21 years, mean age 19.6 years) with stress fracture of the pubic ramus were retrospectively analyzed. Fifty-five cases were military recruits undergoing basic training, and 11 army veterans were undergoing intensive goose step training. Results Sixty-two cases had stress fractures of the inferior pubic ramus including right-sided in 26, left-sided in 30, and bilateral in 6. Four had ipsilateral inferior and superior pubic rami fractures. With 2 weeks after onset, the radiographs were normal in 3 cases. The 66 cases had either a slight transverse fissure (34 cases) or a small dense callus (65 cases) or both during the examination period of 4 weeks to 8 months. Then the calcium resorbed at the margins of the fracture and at the same time the callus increased and surrounded the bone. Finally, the resorptive zone disappeared and the callus became homogeneous. This callus formation persisted for several months and disappeared gradually. Conclusion X-ray examination is the first imaging method of choice for detecting stress fracture of the pubic ramus. With combining clinical data, correct diagnosis can be made in the majority.