Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland,
Skeletal Radiol. 2014 Apr;43(4):507-12. doi: 10.1007/s00256-014-1819-4. Epub 2014 Jan 24.
To assess the number and anatomical location of fractures associated with elbow dislocation, to study the correlation between the direction of dislocation and the trauma energy, and to assess radiographs' diagnostic performance characteristics for fractures using MDCT as a reference standard.
A retrospective study was performed at a level 1 trauma center, finding a total of 140 patients who had sustained an elbow dislocation and who had undergone a subsequent MDCT examination. The CT and radiographs of the patient were reviewed by two musculoskeletal radiologists. CT images were analyzed for the site and size of the fracture fragments. In addition, the primary direction of the dislocation, patients' age, and gender were recorded. Trauma energy was also assessed.
One hundred and thirty-four out of 140 patients (96%) had a fracture that was seen on the correlative CT examination. The most common anatomical fracture locations were the coronoid process of the ulna 84 out of 140 (60%), the radial head 75 out of 140 (54%), and the humeral capitellum 57 out of 140 (41%). Multiple fractures were seen in 71 out of 134 (53%) patients with fractures. The left elbow was more commonly dislocated than the right one. The overall sensitivity of the radiographs was 62% and the specificity 96%.
Small fractures and impaction fractures are almost invariably present in elbow dislocations, and half of the patients have more than one fracture. Radiographs have a sensitivity of only 62%. MDCT is an invaluable method for determining the extent of bony injury and revealing occult fractures.
评估与肘关节脱位相关的骨折数量和解剖位置，研究脱位方向与创伤能量之间的相关性，并评估使用 MDCT 作为参考标准时 X 线摄影的诊断性能特征。
在一家 1 级创伤中心进行回顾性研究，共发现 140 例因肘关节脱位并随后接受 MDCT 检查的患者。两名肌肉骨骼放射科医生对患者的 CT 和 X 线片进行了复查。对 CT 图像进行骨折碎片的位置和大小分析。此外，还记录了脱位的主要方向、患者的年龄和性别。还评估了创伤能量。
在 140 例患者中有 134 例（96%）在相关 CT 检查中发现骨折。最常见的解剖骨折部位是尺骨鹰嘴 84 例（60%）、桡骨头 75 例（54%）和肱骨小头 57 例（41%）。有 71 例（53%）骨折患者可见多处骨折。左侧肘部比右侧更易脱位。X 线摄影的总体敏感性为 62%，特异性为 96%。
肘关节脱位几乎总是存在小骨折和嵌插骨折，一半的患者有不止一处骨折。X 线摄影的敏感性仅为 62%。MDCT 是确定骨损伤程度和显示隐匿性骨折的一种非常有价值的方法。
