Fracture mapping of displaced partial articular fractures of the radial head
Fracture mapping of displaced partial articular fractures of the radial head
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DOI：
10.1016/j.jse.2016.01.030
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发表时间：
2016-09-01
影响因子：
3
通讯作者：
Doornberg, Job N.
中科院分区：
文献类型：
--
作者：
Mellema, Jos J.;Eygendaal, Denise;Doornberg, Job N.
背景：识别创伤性肘关节不稳定的模式有助于预测特定的骨折特征和相关损伤。本研究的目的是利用骨折标测技术评估骨折线分布和移位的部分关节桡骨头骨折的位置与创伤性肘关节不稳定的特定模式之间的关系。采用定量的3-HT技术，对66例急性移位的部分关节桡骨头骨折的骨折线分布和位置进行了确定。三维计算机断层扫描重建，允许骨折碎片复位，并采用标准化方法将桡骨头分为四个象限，前臂处于中立位。骨折地图的定性和定量评估的基础上，移位的部分关节桡骨头骨折和特定的肘骨折patterns之间的骨折特征的关联determined.Results：在部分关节桡骨头骨折，最高骨折线强度位于前外侧象限的中心附近的桡骨头。骨折位置与骨折线分布一致;大多数骨折涉及前外侧象限（n = 65; 98%），而少数骨折涉及后内侧象限的部分（n = 10; 15%）。骨折线分布和位置与骨折图上所示手肘关节整体骨折模式之间的相关性在统计学上并不显著。骨折图显示骨折线分布和桡骨头移位部分关节骨折的位置与创伤性肘关节不稳定的总体特定模式之间没有关联，提示在大多数患者中涉及桡骨头前外侧部分的常见骨折机制。(C)2016年《肩肘外科杂志》董事会。All rights reserved.
Background: Recognition of patterns of traumatic elbow instability helps anticipate specific fracture characteristics and associated injuries. The objective of this study was to assess the association of fracture line distribution and location of displaced partial articular radial head fractures with specific patterns of traumatic elbow instability using fracture mapping techniques.Methods: Fracture line distribution and location of 66 acute displaced partial articular radial head fractures were identified using quantitative 3-dimensional computed tomography reconstructions that allowed reduction of fracture fragments and a standardized method to divide the radial head into quadrants with forearm in neutral position. Based on qualitative and quantitative assessment of fracture maps, the association between fracture characteristics of displaced partial articular radial head fractures and specific elbow fracture patterns was determined.Results: In partial articular radial head fractures, the highest fracture line intensity was located in the anterolateral quadrant near the center of the radial head. Fracture location corresponded with fracture line distribution; most fractures involved the anterolateral quadrant (n = 65; 98%), whereas parts of the posteromedial quadrant were involved in a minority of the fractures (n = 10; 15%). The association of fracture line distribution and location with overall fracture patterns of the elbow, as depicted on fracture maps, was not statistically significant.Conclusion: Fracture maps demonstrated no association between fracture line distribution and location of displaced partial articular fractures of the radial head and overall specific patterns of traumatic elbow instability, suggesting a common fracture mechanism that involves the anterolateral part of the radial head in most patients. (C) 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.