Tiel-van Buul M M, Bos K E, Dijkstra P F, van Beek E J, Broekhuizen A H
Department of Nuclear Medicine, University of Amsterdam, The Netherlands.
Injury. 1993 Apr;24(4):257-62. doi: 10.1016/0020-1383(93)90182-6.
To determine the incidence of carpal instability and its relation to clinical findings in patients with suspected scaphoid fracture, we performed a long-term follow-up investigation in a consecutive series of 160 patients who were treated in our department of traumatology for suspected scaphoid fracture after a fall on the outstretched hand. Radiography of the carpus was obtained. Bone scintigraphy was performed in all patients with negative initial radiographs. Follow-up investigation was performed in 100 patients and consisted of history, clinical examination, including measurement of grip strength and wrist movement, synovia stress test, Watson's scaphoid test, and radiographic examination. In 22 patients, clinical or radiological signs of carpal instability were found. The incidence of complaints and a positive synovia test were significantly higher in patients with suspected carpal instability. The bone scan was not useful for the detection or exclusion of carpal instability. The three-phase bone scan gave no additional information in the diagnosis of carpal instability.
为了确定疑似舟骨骨折患者腕关节不稳定的发生率及其与临床发现的关系，我们对在我科创伤科因伸直手着地后疑似舟骨骨折接受治疗的连续160例患者进行了长期随访调查。拍摄了腕关节X线片。所有初次X线片阴性的患者均进行了骨闪烁显像。对100例患者进行了随访调查，包括病史、临床检查，包括握力和腕关节活动度测量、滑膜应力试验、沃森舟骨试验以及X线检查。在22例患者中发现了腕关节不稳定的临床或放射学征象。疑似腕关节不稳定的患者中，主诉和滑膜试验阳性的发生率显著更高。骨扫描对腕关节不稳定的检测或排除没有帮助。三相骨扫描在腕关节不稳定的诊断中没有提供额外信息。
