Hofsli Mikael, Torfing Trine, Al-Aubaidi Zaid
aDepartment of Ophthalmology, Naestved Hospital Departments of bRadiology cOrthopedics, Odense University hospital, Odense, Denmark.
J Pediatr Orthop B. 2016 Mar;25(2):126-32. doi: 10.1097/BPB.0000000000000248.
Ankle injuries are common among the paediatric population. There are few prospective studies utilizing MRI to diagnose a clinically suspected Salter-Harris type I of the distal fibula (SH1FDF). The aim of this study was to examine the proportion of clinically suspected SH1FDF in children. All paediatric patients with ankle injury, seen at the emergency room from September 2012 to May 2013 at a single institution, underwent a standardized clinical examination, and their radiographs were obtained if found necessary. All images and data were recorded prospectively and patients suspected of having SH1FDF were referred for MRI of the ankle joint. Out of 391 paediatric patients seen at the emergency room with ankle injury, 38 patients had a clinical suspicion of SH1FDF. A total of 31 patients, 18 male and 13 female, with a mean age of 10 ± 2.86 years, were included in the study. Only seven patients were excluded from the study. MRI was obtained on an average of 6.9 ± 2.87 days. None of the included patients had evidence of SH1FDF on MRI. Our study and review of the literature verifies the high false-positive rate of clinically suspected SH1FDF. Most children had ligamentous lesions, bone contusion or joint effusion, rather than SH1FDF.
踝关节损伤在儿童群体中很常见。利用磁共振成像（MRI）诊断临床疑似的腓骨远端Salter-Harris I型骨折（SH1FDF）的前瞻性研究较少。本研究的目的是调查儿童中临床疑似SH1FDF的比例。2012年9月至2013年5月在某单一机构急诊室就诊的所有踝关节损伤儿科患者均接受了标准化临床检查，必要时拍摄X线片。所有图像和数据均前瞻性记录，疑似患有SH1FDF的患者被转诊进行踝关节MRI检查。在急诊室就诊的391例踝关节损伤儿科患者中，38例临床疑似SH1FDF。共有31例患者纳入研究，其中男性18例，女性13例，平均年龄10±2.86岁。仅7例患者被排除在研究之外。MRI平均在6.9±2.87天进行。纳入研究的患者中，MRI均未显示SH1FDF的证据。我们的研究及文献回顾证实了临床疑似SH1FDF的高假阳性率。大多数儿童有韧带损伤、骨挫伤或关节积液，而非SH1FDF。
