Itamura John, Roidis Nikolaos, Mirzayan Raffy, Vaishnav Suke, Learch Thomas, Shean Chris
Department of Orthopaedics, University of South California, Los Angeles, CA, USA.
J Shoulder Elbow Surg. 2005 Jul-Aug;14(4):421-4. doi: 10.1016/j.jse.2004.11.003.
The purpose of this study was to evaluate the incidence of combined osteochondral and ligamentous injuries by magnetic resonance imaging (MRI) in 24 patients with an acute radial head fracture (Mason type II and III) without documented dislocation or tenderness at the distal radioulnar joint. Elbow radiographs (anteroposterior and lateral views) were obtained on all patients as well as magnetic resonance images in the sagittal, coronal, axial, axial oblique, and coronal oblique planes with the injured elbow in a splint. The incidence of associated injuries revealed by MRI was medial collateral ligament not intact in 13 of 24 (54.16%), lateral ulnar collateral ligament not intact in 18 of 24 (80.1%), both collateral ligaments not intact in 12 of 24 (50%), capitellar osteochondral defects in 7 of 24 (29.1%), capitellar bone bruises in 23 of 24 (95.83%), and loose bodies in 22 of 24 (91.67%). A high level of suspicion should be used when one is treating displaced or comminuted radial head fractures, because concurrent osteochondral injuries and/or ligamentous injuries may be present.
本研究的目的是通过磁共振成像（MRI）评估24例急性桡骨头骨折（Mason II型和III型）且无桡尺远侧关节脱位或压痛记录的患者中合并骨软骨和韧带损伤的发生率。对所有患者均拍摄了肘部X线片（正位和侧位），并在受伤肘部用夹板固定的情况下，获取了矢状面、冠状面、轴位、斜轴位和斜冠状面的磁共振图像。MRI显示的相关损伤发生率为：内侧副韧带不完整24例中有13例（54.16%），尺侧副韧带不完整24例中有18例（80.1%），双侧副韧带不完整24例中有12例（50%），肱骨小头骨软骨缺损24例中有7例（29.1%），肱骨小头骨挫伤24例中有23例（95.83%），游离体24例中有22例（91.67%）。在治疗移位或粉碎性桡骨头骨折时应高度怀疑，因为可能存在并发的骨软骨损伤和/或韧带损伤。
