Loesaus Julia, Wobbe Isabel, Stahlberg Erik, Barkhausen Joerg, Goltz Jan Peter
Department for Radiology, Neuroradiology and Nuclear Medicine, University Hospital of Schleswig-Holstein, 23538 Lübeck, Germany.
World J Radiol. 2017 Sep 28;9(9):359-364. doi: 10.4329/wjr.v9.i9.359.
To evaluate the reliability of pronator quadratus fat pad sign to detect distal radius fracture and to predict its severity.
Retrospectively we identified 89 consecutive patients (41 female, mean age 49 ± 18 years) who had X-ray (CR) and computed tomography (CT) within 24 h following distal forearm trauma. Thickness of pronator quadratus fat pad complex (PQC) was measured using lateral views (CR) and sagittal reconstructions (CT). Pearson's test was used to determine the correlation of the PQC thickness in CR and CT. A positive pronator quadratus sign (PQS) was defined as a PQC > 8.0 mm (female) or > 9.0 mm (male). Frykman classification was utilized to assess the severity of fractures.
Forty-four/89 patients (49%) had a distal radius fracture (Frykman I = 3, II = 0, III = 10, IV = 5, V = 2, VI = 2, VII = 9, VIII = 13). Mean thickness of the PQC thickness can reliably be measured on X-ray views and was 7.5 ± 2.8 mm in lateral views (CR), respectively 9.4 ± 3.0 mm in sagittal reconstructions (CT), resulting in a significant correlation coefficient of 0.795. A positive PQS at CR was present in 21/44 patients (48%) with distal radius fracture and in 2/45 patients (4%) without distal radius fracture, resulting in a specificity of 96% and a sensitivity of 48% for the detection of distal radius fractures. There was no correlation between thickness of the PQC and severity of distal radius fractures.
A positive PQS shows high specificity but low sensitivity for detection of distal radius fractures. The PQC thickness cannot predict the severity of distal radius fractures.
评估旋前方肌脂肪垫征检测桡骨远端骨折及其严重程度预测的可靠性。
回顾性分析89例连续患者（41例女性，平均年龄49±18岁），这些患者在前臂远端创伤后24小时内接受了X线（CR）和计算机断层扫描（CT）检查。使用侧位片（CR）和矢状面重建（CT）测量旋前方肌脂肪垫复合体（PQC）的厚度。采用Pearson检验确定CR和CT中PQC厚度的相关性。阳性旋前方肌征（PQS）定义为PQC>8.0mm（女性）或>9.0mm（男性）。采用Frykman分类法评估骨折的严重程度。
89例患者中有44例（49%）发生桡骨远端骨折（Frykman I型=3例，II型=0例，III型=10例，IV型=5例，V型=2例，VI型=2例，VII型=9例，VIII型=13例）。PQC厚度的平均值在X线片上可以可靠测量，侧位片（CR）为7.5±2.8mm，矢状面重建（CT）为9.4±3.0mm，相关系数为0.795，具有显著相关性。44例桡骨远端骨折患者中有21例（48%）在CR上出现阳性PQS，45例无桡骨远端骨折患者中有2例（4%）出现阳性PQS，检测桡骨远端骨折的特异性为96%，敏感性为48%。PQC厚度与桡骨远端骨折的严重程度之间无相关性。
阳性PQS对桡骨远端骨折的检测具有高特异性但低敏感性。PQC厚度不能预测桡骨远端骨折的严重程度。
