Kob A, Lang A, Thelen R, Schild H
Institut für Klinische Strahlenkunde der Johannes-Gutenberg-Universität, Mainz.
Rontgenblatter. 1988 May;41(5):215-20.
To visualise the rupture of the scaphoid bone it will be sufficient--as has been proven--to perform two additional projections from the navicular series besides the standard x-rays of the wrist joint, namely, with the hand in writing-pen position and in hyperpronation. With this procedure, almost all (99%) of fractures detected during first examination can be diagnosed. To prove the occurrence of fractures of the wrist besides those of the os naviculare, specific x-rays are employed in accordance with the results of an on-target clinical examination. Such x-rays are, in particular: lateral radioulnar x-ray rotated by 10 degrees in volar direction to assess the os triquetrum; lateral radioulnar x-ray in 10-30 degrees supination to visualise the os pisiforme; carpal tunnel x-ray to assess the entire hollow of the hand, in particular the volar parts of os pisiforme, os hamatum (hamulus) and os trapezium. Although such fractures can partly also be diagnosed by means of a navicular series, as already stated, it is not permissible to exclude the presence of a fracture if there are no abnormal findings in the navicular quartet whereas clinical findings are positive.
为了观察舟状骨骨折情况,事实证明,除了腕关节的标准X线片外,再进行舟状骨系列的另外两个投照即可,即手部呈握笔姿势和极度旋前位。通过这种方法,首次检查时发现的几乎所有(99%)骨折都能被诊断出来。为了证实除舟状骨骨折外腕部其他骨折的存在,根据针对性临床检查结果采用特定的X线片。这些X线片尤其包括:掌侧方向旋转10度的尺桡侧位X线片,用于评估三角骨;旋前10 - 30度的尺桡侧位X线片,用于观察豌豆骨;腕管X线片,用于评估整个手掌部,特别是豌豆骨、钩骨(钩)和大多角骨的掌侧部分。尽管如前所述,此类骨折部分也可通过舟状骨系列诊断,但如果舟状骨四联组没有异常发现而临床检查结果为阳性,也不能排除骨折的存在。