Shahabpour Maryam, Abid Wiem, Van Overstraeten Luc, De Maeseneer Michel
Free University of Brussels, BE.
J Belg Soc Radiol. 2021 Dec 31;105(1):90. doi: 10.5334/jbsr.2709. eCollection 2021.
Acute and subacute wrist trauma predominantly consist of fractures of the distal radius in elderly patients and most frequently carpal fractures (scaphoid, followed by triquetrum and hamatum) and avulsion fractures of the ulnar styloid in younger patients, especially in sports-related injuries but also in work activities. The initial radiographs may miss the fractures and result when untreated in complications as nonunion, osteonecrosis, and degenerative osteoarthritis. Fractures of the distal radius and of the scaphoid may be associated with ligament injuries, most frequently the scapholunate complex, which are often overlooked at the emergency department. Patients without osseous injuries may present intrinsic and extrinsic ligament tears that may lead to carpal instability when they are clinically and/or radiologically missed. Therefore, in acute and subacute setting, computed tomography may be helpful for the detection of subtle fractures, and magnetic resonance imaging, for the early diagnosis of occult fractures and ligament injuries.
急性和亚急性腕部创伤在老年患者中主要表现为桡骨远端骨折，而在年轻患者中最常见的是腕骨骨折（舟骨骨折最为常见，其次是三角骨和钩骨骨折）以及尺骨茎突撕脱骨折，尤其在与运动相关的损伤中，但在工作活动中也会出现。最初的X线片可能会漏诊骨折，若不治疗，可能会导致骨不连、骨坏死和退行性骨关节炎等并发症。桡骨远端骨折和舟骨骨折可能伴有韧带损伤，最常见的是舟月复合体损伤，而这些损伤在急诊科常常被忽视。没有骨质损伤的患者可能存在内在和外在韧带撕裂，若在临床和/或放射学检查中漏诊，可能会导致腕关节不稳定。因此，在急性和亚急性情况下，计算机断层扫描有助于检测细微骨折，而磁共振成像则有助于早期诊断隐匿性骨折和韧带损伤。
