McGinley Joseph C, Gold Garry, Cheung Emilie, Yao Jeffrey
Department of Radiology, Stanford University Medical Center, Stanford, CA USA ; McGinley Orthopaedic Innovations, 5910 S Cedar St, Casper, WY 82601 USA.
Department of Radiology, Stanford University Medical Center, Stanford, CA USA.
Hand (N Y). 2014 Mar;9(1):87-92. doi: 10.1007/s11552-013-9561-2.
This study aims to evaluate the incidence of forearm soft tissue abnormalities associated with radial head fracture severity based on the Mason classification system.
Eighteen patients (age 18-45 years) were prospectively evaluated with elbow radiographs and magnetic resonance imaging (MRI) following longitudinal forearm trauma. MRI was performed within 10 days of the initial injury. Radiographs and MR images were evaluated in a blinded fashion by two musculoskeletal radiologists.
Thirteen of 18 patients presented with Mason type I radial head fractures. In all patients with Mason type I fractures, the interosseous membrane (IOM) was intact. Two patients had Mason type II fractures with associated partial and compete tearing of the IOM and three patients had Mason type III fractures with complete tearing of the IOM. Edema was noted in the pronator quadratus in six of 13 type I injuries and seen in all type II and III injuries. No structural forearm soft tissue abnormalities were present in patients with Mason type I injuries. The presence of edema within the pronator quadratus correlated with distal forearm pain.
The severity of radial head fracture correlates with longitudinal forearm injury evidenced by the presence of IOM tearing. The findings suggest patients with Mason type II or III fractures of the radial head should undergo further evaluation of the forearm for associated soft tissue injuries. Edema within the pronator quadratus was present following forearm trauma regardless of the severity of fracture and was related to symptomatic forearm pain.
本研究旨在基于梅森分类系统评估与桡骨头骨折严重程度相关的前臂软组织异常的发生率。
对18例年龄在18至45岁之间的患者进行前瞻性评估，这些患者在遭受前臂纵向创伤后接受了肘部X光片和磁共振成像（MRI）检查。MRI在初次受伤后10天内进行。两名肌肉骨骼放射科医生以盲法评估X光片和MR图像。
18例患者中有13例出现梅森I型桡骨头骨折。在所有梅森I型骨折患者中，骨间膜（IOM）均完整。2例患者为梅森II型骨折，伴有IOM部分和完全撕裂，3例患者为梅森III型骨折，IOM完全撕裂。在13例I型损伤中的6例患者的旋前方肌中发现水肿，在所有II型和III型损伤中均可见水肿。梅森I型损伤患者未出现前臂软组织结构异常。旋前方肌内水肿的存在与前臂远端疼痛相关。
桡骨头骨折的严重程度与IOM撕裂所证明的前臂纵向损伤相关。研究结果表明，桡骨头梅森II型或III型骨折患者应进一步评估前臂是否存在相关软组织损伤。无论骨折严重程度如何，前臂创伤后旋前方肌内均会出现水肿，且与有症状的前臂疼痛有关。
