Department of Radiology, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK.
Clin Radiol. 2011 Nov;66(11):1049-54. doi: 10.1016/j.crad.2011.06.001. Epub 2011 Jul 18.
To document the timing of the appearance of the radiological features of fracture healing in a group of infants in which the date of injury was known and to assess the degree of interobserver agreement.
Three paediatric radiologists independently assessed 161 images of 37 long bone fractures in 31 patients aged 0-44 months. The following features were assessed: soft-tissue swelling, subperiosteal new bone formation (SPNBF), definition of fracture line, presence or absence of callus, whether callus was well or ill defined, and the presence of endosteal callus.
Agreement between observers was only moderate for all discriminators except SPNBF. SPNBF was invariably seen after 11 days but was uncommon before this time even in the very young. In one case SPNBF was seen at 4 days.
With the exception of SPNBF, the criteria relied on to date fractures are either not reproducible or are poor discriminators of fracture age.
记录一组已知受伤日期的婴儿骨折愈合的放射学特征出现的时间，并评估观察者间的一致性程度。
3 名儿科放射科医生对 31 名 0-44 个月大的患者的 37 处长骨骨折的 161 张图像进行了独立评估。评估的特征包括：软组织肿胀、骨膜下新骨形成（SPNBF）、骨折线清晰度、骨痂的存在与否、骨痂的清晰度以及骨内膜骨痂的存在。
除 SPNBF 外，所有鉴别指标的观察者间一致性仅为中度。SPNBF 通常在 11 天后出现，但即使在非常年幼的患者中，在此之前也很少见。有一例患者在 4 天时就出现了 SPNBF。
除 SPNBF 外，用于确定骨折时间的标准要么不可重现，要么对骨折年龄的鉴别能力较差。
