Wang C L, Shieh J Y, Wang T G, Hsieh F J
Department of Orthopedic Surgery, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei, Taiwan.
J Clin Ultrasound. 1999 Oct;27(8):421-5. doi: 10.1002/(sici)1097-0096(199910)27:8<421::aid-jcu2>3.0.co;2-e.
The purpose of this retrospective study was to determine whether high-resolution sonography can aid in the diagnosis of radiographically occult fractures in the foot and ankle.
High-resolution sonography with a 10-MHz linear-array transducer was performed in 268 patients with foot and ankle injuries whose initial plain x-ray films were negative for fracture.
Twenty-four patients had occult fractures demonstrated by sonography. On sonography, the occult fractures appeared as a discontinuity of cortex echogenicity. The fractures were found at the calcaneus (n = 8), metatarsus (n = 6), talus (n = 3), navicular bone (n = 3), cuboid bone (n = 2), cuneiform bone (n = 1), and lateral malleolus (n = 1). Review of the patients' radiographs revealed tiny fractures at the sonographically identified locations in 2 patients. The first 5 patients underwent bone scans, which confirmed the presence of the fractures. The first 11 patients received follow-up sonographic examination 6 weeks after diagnosis; in all 11, an echogenic line over the previous fracture site, presumably representing callus formation, was noted.
Sonography-a readily available, noninvasive imaging technique-can provide important information about soft tissue injuries and cortical discontinuities in the foot and ankle area. Using this procedure, occult fractures can be identified and delineated, and costly procedures such as MRI can be avoided.
本回顾性研究的目的是确定高分辨率超声是否有助于诊断足踝部X线隐匿性骨折。
对268例足踝部损伤患者进行了高分辨率超声检查，这些患者最初的X线平片未显示骨折。
超声检查发现24例隐匿性骨折。在超声图像上，隐匿性骨折表现为皮质回声连续性中断。骨折部位包括跟骨（n = 8）、跖骨（n = 6）、距骨（n = 3）、舟骨（n = 3）、骰骨（n = 2）、楔骨（n = 1）和外踝（n = 1）。复查患者的X线片发现，2例患者在超声确定的部位有微小骨折。前5例患者进行了骨扫描，证实了骨折的存在。前11例患者在诊断后6周接受了超声随访检查；在所有11例患者中，均在先前骨折部位发现一条回声线，推测代表骨痂形成。
超声作为一种易于获得的非侵入性成像技术，可以提供有关足踝部软组织损伤和皮质连续性中断的重要信息。通过这种检查方法，可以识别和描绘隐匿性骨折，避免使用如MRI等昂贵的检查。
