Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Skeletal Radiol. 2020 Dec;49(12):2011-2018. doi: 10.1007/s00256-020-03522-9. Epub 2020 Jun 25.
To systematically investigate age-dependent changes in scaphoid fracture prevalence and fracture patterns on radiographs in children under 15 years of age.
This retrospective study included children with scaphoid fractures, who underwent radiographic examinations between May 1, 2009, and August 31, 2019. Blinded to outcome, all radiographs were reviewed to determine fracture visibility on initial radiographs; to characterize fracture location (distal corner, distal, mid, and proximal body) and orientation (horizontal oblique, transverse, and vertical oblique); and to identify the presence or absence of gap, displacement, and concomitant fractures. Demographic information and information on weight and height were collected. Mann-Whitney U, Kruskal-Wallis rank sum, chi-square, and post hoc tests were used to investigate associations between age, fracture characteristics, and BMI percentile.
The study included 180 children (134 boys and 46 girls; 12.3 ± 1.4 years) with 59 (33%) distal corner, 42 (23%) distal, 76 (42%) mid, and 3 (2%) proximal body fractures. Younger children were more likely to present with distal corner and distal body fractures while older children with mid and proximal body fractures (p = 0.035). No association was found between age and fracture visibility (p = 0.246), fracture orientation (p = 0.752), presence of gap (p = 0.130), displacement (p = 0.403), or concomitant fractures (p = 0.588). Younger children with scaphoid fractures were more likely to be obese (n = 117; p = 0.038).
Scaphoid fractures of the distal corner and distal body were significantly more common in younger children, who are more likely to be obese.
系统研究 15 岁以下儿童的腕舟骨骨折发生率和 X 线片骨折类型随年龄的变化。
本回顾性研究纳入了 2009 年 5 月 1 日至 2019 年 8 月 31 日期间接受 X 线检查的腕舟骨骨折患儿。所有 X 线片均由不知晓结果的观察者进行盲法阅片，以确定初始 X 线片上骨折的可见性；确定骨折部位（远侧角、远侧、中段和近侧体）和方向（水平斜形、横形和垂直斜形）；并确定是否存在间隙、移位和伴发骨折。收集了人口统计学信息以及体重和身高信息。采用 Mann-Whitney U 检验、Kruskal-Wallis 秩和检验、卡方检验和事后检验来分析年龄、骨折特征和 BMI 百分位数之间的关系。
本研究纳入了 180 名儿童（男 134 例，女 46 例；12.3±1.4 岁），其中 59 例（33%）为远侧角骨折，42 例（23%）为远侧骨折，76 例（42%）为中段骨折，3 例（2%）为近侧体骨折。年龄较小的患儿更可能发生远侧角和远侧体骨折，而年龄较大的患儿更可能发生中段和近侧体骨折（p=0.035）。年龄与骨折可见性（p=0.246）、骨折方向（p=0.752）、间隙存在（p=0.130）、移位（p=0.403）或伴发骨折（p=0.588）之间均无相关性。发生腕舟骨骨折的年龄较小的患儿更可能肥胖（n=117；p=0.038）。
远侧角和远侧体的腕舟骨骨折在年龄较小的儿童中更为常见，这些患儿更可能肥胖。
