Radiographic measurements was performed on 124 normal adults for anterior, posterior and middle heights of the vertebral bodies in thoracic and lumbar spine. The normal ratios of vertebral height in one vertebral body...Radiographic measurements was performed on 124 normal adults for anterior, posterior and middle heights of the vertebral bodies in thoracic and lumbar spine. The normal ratios of vertebral height in one vertebral body and one with the adjacent bodies were presented. The method for measurement and its diagnostic value to osteoporotic vertebral fractures were discussed.展开更多
Purpose: Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultraso...Purpose: Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography (USG) has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography. Methods: In this cross-sectional study, consecutive patients with minor blunt chest trauma and suspected rib fractures presenting in Imam Reza Hospital located in Mashhad-Iran, between April 2013 and October 2013 were assessed by USG and radiography. The radiography was performed in a posteroanterior (PA) chest projection and oblique rib view centered over the area of trauma. The time duration spent in taking USG and radiography were recorded. The prevalence and location of fractures revealed by USG and radiography were compared. Results: Sixty-one suspected patients were assessed. The male to female ratio was 2.4:1 (43 men and 18 women) with a mean ± SD age of (44.3 ± 19.7) years. There were totally 59 rib fractures in 38 (62.3%) patients based on radiography and USG, while 23 (37.7%) patients had no diagnostic evidence of rib lesions. USG revealed 58 rib fractures in 33 (54.1%) of 61 suspected patients and radiographs revealed 32 rib fractures in 20 (32.8%) of 61 patients. A total of 58 (98.3%) rib fractures were detected by USG, whereas oblique rib view and PA chest radiography showed 27 (45.8%) and 24 (40.7%) rib fractures, respectively. The average duration of USG was (12 ± 3) min (range 7e17 min), whereas the duration of radiography was (27 ± 6) min (range 15-37 min). The kappa coefficient showed a low level of agreement between both USG and PA chest radiography (kappa coefficient=0.28), and between USG and oblique rib view (kappa coefficient=0.32). Conclusion: USG discloses more fractures than radiography in most patients presenting with suspected rib fractures. Moreover USG requires significantly less time than radiography.展开更多
Objective: To evaluate the usefulness of two- dimensional (2D) and three-dimensional (3D) computed tomography (CT) in the identification and classification of Le Fort type fractures. Methods: Sixty-two patients with d...Objective: To evaluate the usefulness of two- dimensional (2D) and three-dimensional (3D) computed tomography (CT) in the identification and classification of Le Fort type fractures. Methods: Sixty-two patients with different types of Le Fort fractures underwent CT scanning and 3D-CT reconstruction. The data were analyzed by multiplanar reconstruction (MPR), surface shaded display (SSD) and volume rendering (VR) respectively. Results: The patients with Le Fort Ⅰ, Le Fort Ⅱ fracture and Le Fort Ⅲ fracture accounted for 16.1%, 14.5% and 12.9% respectively. The compound fractures were the most common type and accounted for 56.5% (n=35, 18 cases with Le FortⅠ+Ⅱ fracture, 10 cases with Le Fort Ⅱ+Ⅲ fracture and 7 cases with Le FortⅠ+ Ⅱ+Ⅲ fracture). Fifty-five cases coexisted with other fractures in maxillofacial region. 2D-CT could be used to define the tiny fractures and the deep-structure fractures more accurately compared with 3D-CT, but the real impression of Le Fort type fractures could not be correctly evaluated on 2D-CT. 3D-CT could clearly demonstrate the whole shape of Le Fort type fractures and identify the classification of Le Fort fractures. Conclusions: 3D-CT is the best imaging method for the diagnosis of Le Fort type fractures and can provide valuable information of space relationship, especially for the design of treatment plan before operation.展开更多
Purpose: The aim of this study is to discuss the results of different intramedullary devices used in the management of paediatric radial neck fractures and to suggest methods to avoid the pitfalls of the technique. M...Purpose: The aim of this study is to discuss the results of different intramedullary devices used in the management of paediatric radial neck fractures and to suggest methods to avoid the pitfalls of the technique. Methods: Thirty patients with isolated Judet III and IV fractures were included in this prospective study. Judet I and II fractures and radial neck fractures associated with other injuries were excluded. The final results were graded using the Metaizeau functional scoring system and Oxford Elbow Score. Results: The functional result was good to excellent in 24 of 30 cases (80%). The mean Oxford Elbow Score was 44.32. The mean follow-up was 40.11 months. The complications seen were radiocapitellar joint penetration - 6 cases at mean 4.87 weeks, redisplacement - 6, radial epiphyseal sclerosis - 5, and heterotopic ossification 1 case. Conclusion: lntramedullary K wires may result in radiocapitellar joint penetration. Titanium Elastic Nail System should not be used as purely fixation devices as they may not prevent redisplacement. Regular follow-up until at least 6 weeks is essential. Patients who have a Judet IV fracture and need open reduction should be given a guarded prognosis. The paper highlights the pitfalls of the technique and makes recommendations regarding the type of implant, follow-up and patient counselling in Judet IV fractures.展开更多
文摘Radiographic measurements was performed on 124 normal adults for anterior, posterior and middle heights of the vertebral bodies in thoracic and lumbar spine. The normal ratios of vertebral height in one vertebral body and one with the adjacent bodies were presented. The method for measurement and its diagnostic value to osteoporotic vertebral fractures were discussed.
文摘Purpose: Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography (USG) has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography. Methods: In this cross-sectional study, consecutive patients with minor blunt chest trauma and suspected rib fractures presenting in Imam Reza Hospital located in Mashhad-Iran, between April 2013 and October 2013 were assessed by USG and radiography. The radiography was performed in a posteroanterior (PA) chest projection and oblique rib view centered over the area of trauma. The time duration spent in taking USG and radiography were recorded. The prevalence and location of fractures revealed by USG and radiography were compared. Results: Sixty-one suspected patients were assessed. The male to female ratio was 2.4:1 (43 men and 18 women) with a mean ± SD age of (44.3 ± 19.7) years. There were totally 59 rib fractures in 38 (62.3%) patients based on radiography and USG, while 23 (37.7%) patients had no diagnostic evidence of rib lesions. USG revealed 58 rib fractures in 33 (54.1%) of 61 suspected patients and radiographs revealed 32 rib fractures in 20 (32.8%) of 61 patients. A total of 58 (98.3%) rib fractures were detected by USG, whereas oblique rib view and PA chest radiography showed 27 (45.8%) and 24 (40.7%) rib fractures, respectively. The average duration of USG was (12 ± 3) min (range 7e17 min), whereas the duration of radiography was (27 ± 6) min (range 15-37 min). The kappa coefficient showed a low level of agreement between both USG and PA chest radiography (kappa coefficient=0.28), and between USG and oblique rib view (kappa coefficient=0.32). Conclusion: USG discloses more fractures than radiography in most patients presenting with suspected rib fractures. Moreover USG requires significantly less time than radiography.
文摘Objective: To evaluate the usefulness of two- dimensional (2D) and three-dimensional (3D) computed tomography (CT) in the identification and classification of Le Fort type fractures. Methods: Sixty-two patients with different types of Le Fort fractures underwent CT scanning and 3D-CT reconstruction. The data were analyzed by multiplanar reconstruction (MPR), surface shaded display (SSD) and volume rendering (VR) respectively. Results: The patients with Le Fort Ⅰ, Le Fort Ⅱ fracture and Le Fort Ⅲ fracture accounted for 16.1%, 14.5% and 12.9% respectively. The compound fractures were the most common type and accounted for 56.5% (n=35, 18 cases with Le FortⅠ+Ⅱ fracture, 10 cases with Le Fort Ⅱ+Ⅲ fracture and 7 cases with Le FortⅠ+ Ⅱ+Ⅲ fracture). Fifty-five cases coexisted with other fractures in maxillofacial region. 2D-CT could be used to define the tiny fractures and the deep-structure fractures more accurately compared with 3D-CT, but the real impression of Le Fort type fractures could not be correctly evaluated on 2D-CT. 3D-CT could clearly demonstrate the whole shape of Le Fort type fractures and identify the classification of Le Fort fractures. Conclusions: 3D-CT is the best imaging method for the diagnosis of Le Fort type fractures and can provide valuable information of space relationship, especially for the design of treatment plan before operation.
文摘Purpose: The aim of this study is to discuss the results of different intramedullary devices used in the management of paediatric radial neck fractures and to suggest methods to avoid the pitfalls of the technique. Methods: Thirty patients with isolated Judet III and IV fractures were included in this prospective study. Judet I and II fractures and radial neck fractures associated with other injuries were excluded. The final results were graded using the Metaizeau functional scoring system and Oxford Elbow Score. Results: The functional result was good to excellent in 24 of 30 cases (80%). The mean Oxford Elbow Score was 44.32. The mean follow-up was 40.11 months. The complications seen were radiocapitellar joint penetration - 6 cases at mean 4.87 weeks, redisplacement - 6, radial epiphyseal sclerosis - 5, and heterotopic ossification 1 case. Conclusion: lntramedullary K wires may result in radiocapitellar joint penetration. Titanium Elastic Nail System should not be used as purely fixation devices as they may not prevent redisplacement. Regular follow-up until at least 6 weeks is essential. Patients who have a Judet IV fracture and need open reduction should be given a guarded prognosis. The paper highlights the pitfalls of the technique and makes recommendations regarding the type of implant, follow-up and patient counselling in Judet IV fractures.