仰卧敬礼位拍摄肘关节侧位片在初诊儿童肱骨髁上骨折中的应用研究

Application of Lateral Radiographs of Elbow Taken in Supine Saluting Position in Newly Diagnosed Children with Supracondylar Fracture of Humerus

目的评价仰卧敬礼位拍摄肘关节侧位片在初诊儿童肱骨髁上骨折中的应用价值。方法回顾性分析2019年1月至2020年1月我院收治236例经临床体征检查及后期治疗随访确诊的儿童肱骨髁上骨折患者临床资料,其中120例初诊采用仰卧敬礼位拍摄肘关节侧位X片为A组,116例初诊采用传统体位拍摄肘关节侧位X片为B组。比较两组患者初诊检查标准肘关节侧位影像合格率,总诊断准确率,Gartland分型诊断(Ⅰ、Ⅱ、Ⅲ)准确率。结果两组初诊检查标准肘关节侧位影像合格率A组(90.8%)与B组(48.2%)比较,差异有统计学意义(P<0.05)。总诊断准确率A组(95.8%)与B组(71.6%)比较,差异有统计学意义(P<0.05)。GartlandⅠ型诊断准确率中A组(85.7%)与B组(40.0%)比较,差异有统计学意义(P<0.05)。GartlandⅡ型诊断准确率中A组(94.7%)与B组(53.1%)比较,差异有统计学意义(P<0.05)。GartlandⅢ型诊断准确率中A组(100%)与B组(100%)比较,差异无统计学意义(P>0.05)。结论仰卧敬礼位拍摄肘关节侧位片在初诊儿童肱骨髁上骨折中可获得较高标准肘关节侧位影像图片,提高儿童肱骨髁上骨折诊断准确率,尤其是GartlandⅠ型及Ⅱ型,值得在临床上推广。

Objective To evaluate application values of lateral radiographs of elbow taken in supine salute position in newly diagnosed children with supracondylar fracture of humerus.Methods From January 2019 to January 2020,according to certain inclusion and exclusion criteria,clinical data of 236 children with supracondylar fracture of humerus admitted to our hospital were retrospectively analyzed after clinical signs examination and later treatment follow-up.120 patients received lateral radiographs of elbow in supine saluting position(group A),and 116 patients received lateral radiographs of elbow in traditional position(group B).Qualified rate,total diagnostic accuracy and accuracy of Gartland classification(Ⅰ、Ⅱ、Ⅲ)were compared.Results Compared with group B(48.2%)and group A(90.8%),there was statistically significant difference(P<0.05).The total diagnostic accuracy of group A(95.8%)was significantly different from group B(71.6%)(P<0.05).The accuracy of Gartland typeⅠdiagnosis was significantly different between group A(85.7%)and group B(40.0%)(P<0.05).The accuracy of Gartland typeⅡdiagnosis was significantly different between group A(94.7%)and group B(53.1%)(P<0.05).There was no significant difference between Gartland group A(100%)and Group B(100%)in the accuracy of Gartland typeⅢdiagnosis(P>0.05).Conclusion Lateral radiographs of elbow in supine saluting position could obtain higher standard lateral radiographs of humeral supracondylar fracture in children,and improve diagnostic accuracy of supracondylar fracture in children,especially GartlandⅠandⅡ,which is worthy of clinical promotion.