Kleinman P K, Marks S C
Department of Radiology, University of Massachusetts Medical Center, Worcester 01655, USA.
J Bone Joint Surg Am. 1995 Oct;77(10):1471-6. doi: 10.2106/00004623-199510000-00001.
We studied the relationship between the subperiosteal bone collar and forty metaphyseal lesions in specimens obtained at autopsy from ten infants who died with evidence of abuse. The fracture specimens were studied with high-detail radiography and light microscopy. The typical morphological pattern was a fracture extending through the primary spongiosa adjacent to the chondro-osseous junction. As the fracture line approached the cortex, it veered away from the growth plate, undercutting a fragment of bone that was thicker peripherally than it was centrally. Histological examination showed that this peripheral fragment of bone included the subperiosteal bone collar. Inclusion of the subperiosteal bone collar within the peripheral portion of the metaphyseal fracture fragment explains the radiographic appearance of corner fractures and bucket-handle patterns described by Caffey in abused infants.
我们研究了从十名死于虐待证据的婴儿尸体解剖标本中获取的骨膜下骨环与四十处干骺端病变之间的关系。对骨折标本进行了高分辨率放射摄影和光学显微镜检查。典型的形态学模式是骨折延伸穿过与软骨-骨交界处相邻的初级海绵骨。当骨折线接近皮质时，它会偏离生长板，在骨碎片下方切割，该骨碎片周边比中央厚。组织学检查表明，这个周边骨碎片包括骨膜下骨环。干骺端骨折碎片周边部分包含骨膜下骨环，这就解释了卡菲所描述的受虐婴儿中角形骨折和桶柄样骨折的放射学表现。
