Castagno A A, Shuman W P, Kilcoyne R F, Haynor D R, Morris M E, Matsen F A
Department of Radiology, University of Washington Hospital, Seattle 98195.
Radiology. 1987 Dec;165(3):759-62. doi: 10.1148/radiology.165.3.3685356.
The authors reviewed the computed tomography (CT) scans, plain radiographs, and subsequent treatment of 17 patients with complex proximal humeral fractures. CT scans and radiographs were compared in the demonstration of fracture lines, displacement of fracture fragments, rotation of fragments relative to their normal positions, and status of the head and articular surface of the humerus. The impact of CT findings on the decision to treat with surgery versus closed reduction and on the choice of surgical procedure was assessed. Surgery was not performed in nine patients because CT scans showed no significant displacement of fragments previously judged displaced or "indeterminate" on radiographs. Surgery was performed in eight patients; CT demonstrated significant abnormalities not definitely shown with radiography. In six of these eight patients, CT scans demonstrated unsuspected abnormalities that directed the choice of surgical procedure. CT scans provide clinically useful information for the treatment of complex proximal humeral fractures when radiographs provide inadequate or indefinite information.
作者回顾了17例复杂肱骨近端骨折患者的计算机断层扫描（CT）、X线平片及后续治疗情况。比较了CT扫描和X线平片在显示骨折线、骨折碎片移位、碎片相对于其正常位置的旋转以及肱骨头部和关节面状况方面的差异。评估了CT检查结果对手术治疗与闭合复位决策以及手术方式选择的影响。9例患者未进行手术，因为CT扫描显示先前在X线片上判断为移位或“不确定”的碎片无明显移位。8例患者进行了手术；CT显示出X线片未明确显示的明显异常。在这8例患者中的6例中，CT扫描显示出意外的异常情况，从而指导了手术方式的选择。当X线片提供的信息不足或不明确时，CT扫描可为复杂肱骨近端骨折的治疗提供临床有用信息。
