肱骨远端全骺分离的X线诊断分析

X-ray diagnosis and analysis of detached omni-epiphysis of distal end of humerus

目的 探讨一种科学量化的方法来评价肱骨远端全骺分离Salter harrisⅡ型骺离 (简称S HⅡ型 )X线诊断依据。方法 查阅了 2 0 0 0多例库存肘关节平片 ,按S H骨骺损伤的诊断标准 ,严格筛选出肱骨远端全骺分离 30例 ,将S HⅡ型平片划线测量撕脱之三角形骨折块底边AO、夹角Q以及干骺端残底BO ,所得数据经统计学处理。结果 肱骨远端全骺分离S HⅡ型Q角波动范围在 30°～ 75° ,平均 4 5° ;AO变动范围为(0 .91± 1 .96 )S(S =0 .1 7) ;AO/BO之比为 (0 .4 1 6± 1 .6 4 5 )S(S =0 .0 8)。追踪观察S HⅠ型骺离随着年龄增大 ,骨折线逐渐转变为经内上髁骨骺延向干骺端桡侧 ,呈现为半弧形。结论 干骺端三角形骨折块Q角在4 5°左右 ,AO/BO <0 .5 5 ,再结合肱骨远端骨化中心全盘尺偏移位 ,即可确诊为S

Objective To find a scientific and quantitative method to evaluate the X ray diagnosis of detached omni epiphysis of distal end of humerus.?Methods We have read a lot of reserved elbow joint X ray films.?Among them,30 cases were strictly screened according to diagnosis standard of epiphyseal injury.?We measured edge AO,clip angle Q and metaphysis incomplete floor BO of the avulsion triangle on S H II lined X ray.?All data were processed by statistic methods.?Results The angle of detached omni epiphysis of distal end of humerus fluctuated between 30° 75°.?The average value was 45°,the AO change range was(0.91±1.96)S(S=0.17).?The ratio AO/BO was(0.416±1.645)S(S= 0.08 ).?We found out that the fracture line of S H I gradually converted from medial epicondyle epiphysis to metaphysis radialis and changed into semi bow form following the increased age in follow up research.?Conclusion The Q angle of metaphysis triangle fracture piece is about 45°,AO/BO<0.55.?Conjugating humerus apo tip ossification center ulnaris displacement,we can finally diagnose detached omni epiphysis of distal end of humerus.