腕舟月不稳X线征象及参数测量的临床意义

The clinical significance of X-ray signs and parameters measurement in wrist scapholunate disstability

目的通过对腕舟月不稳的X线征象分析及参数测量来探讨征象及参数测量的价值,并分析其临床意义。方法回顾性分析21例舟月不稳的病例,并对其X线腕关节正侧位进行分析测量,观察征象包括:舟骨皮质环征、TerryThomas征;测量参数包括:舟月间距(SLG)、舟月角(SLA)及桡月角(RLA),对部分病例对照其MRI的韧带改变。结果舟月不稳的X线征象Terry-Thomas征4例,出现率为19%;舟骨皮质环征14例(阳性率66.7%)。X线测量舟月间距(3.7±1.6)mm(阳性率42.9%),舟月角63.5±18.20(阳性率61.9%),桡月角11.5±4.70(阳性率为57.1%)。X线上出现一种或多种舟月不稳阳性表现的病例为18例,占85.7%。结论 X线是诊断舟月不稳的基本方法,结合X线征象及参数测量能较好提示舟月不稳的诊断,舟月间距及SLA评估舟月不稳价值最大。

Objective To explore the value and clinical significance of X‐ray signs and parameters measurement by analy‐zing the X‐ray signs and measuring several parameters of w rist scapholunate disstability cases .Methods We restropec‐tively analyzed 21 cases of scapholunate disstability ,measured parameters in the wrist posterior‐anterior and lateral projec‐tion ,signs including scaphoid cortical ring sign ,Terry‐Thomas sign including ：scapholunate gap （SLG） ,scapholunate an‐gle （SLA） and radiolunate angle （RLA） ,some cases in contrast to MRI findings .Results Terry‐Thomas sign presents in 4 cases ,the occurrence rate is 19% ;scaphoid cortical ring sign prensents in 14 cases （positive rate：66 .7% ） .Scapholu‐nate gap is （3 .7 ± 1 .6） mm （positive rate：42 .9% ） ,scapholunate angle is 63 .5 ± 18 .20 （positive rate：61 .9% ） ,radiolu‐nate angle is 11 .5 ± 4 .70 （positive rate：57 .1% ） .18 cases have one or more positive X‐ray findings of scapholunate dis‐stability ,the sum positive rate is 85 .7% .Conclusion X‐ray is the basic modality in diagnosing scapholunate disstability , combination of X‐ray signs and parameters measurement can well indicate the diagnosis of scapholunate disstability ,the measurements of scapholunate gap and SLA are more valuable in evaluating scapholunate disstability .