Lazović D, Wegner U, Peters G, Gossé F
Medical School Hannover, Clinic of Orthopedics, Germany.
Knee Surg Sports Traumatol Arthrosc. 1996;3(4):234-7. doi: 10.1007/BF01466625.
Avulsion injuries of the apophysis is a problem in young athletes. A correct diagnosis is necessary for establishing the appropriate treatment and the rehabilitation program. However, it is often difficult to distinguish between a simple muscle strain and an avulsion fracture. The X-ray examination is helpful only when an ossification center of the apophysis exists. Ultrasonography is considered the suitable diagnostic tool for these cases. From June 1988 to June 1993, 243 young athletes were seen with an anamnestic and clinically suspected apophyseal injury of the lower extremity. In all cases X-ray examination and ultrasound examination were performed. In 80 cases the diagnosis was confirmed by X-ray examination and in 97 by ultrasonography. Four criteria were defined for the sonographic examination: (a) a hypoechogenic zone, (b) increased distance to the apophysis, (c) dislocation of the apophysis, and (d) mobility of the apophysis on dynamic examination. These criteria are correlated to (a) edema, (b) lysis, (c) avulsion, and (d) unstable avulsion of the apophysis. Ultrasonography is a proven technique for the detection of apophyseal injuries. In comparison to X-ray examination, it has the advantages of no radiation exposure, early detection even without ossification center, and dynamic examination.
骨骺撕脱伤是年轻运动员面临的一个问题。正确的诊断对于制定合适的治疗方案和康复计划至关重要。然而，区分单纯的肌肉拉伤和撕脱性骨折往往很困难。只有当骨骺的骨化中心存在时，X线检查才会有帮助。超声检查被认为是这些病例合适的诊断工具。从1988年6月到1993年6月，243名年轻运动员因有下肢骨骺损伤的既往史且临床怀疑有此类损伤前来就诊。所有病例均进行了X线检查和超声检查。80例通过X线检查确诊，97例通过超声检查确诊。为超声检查定义了四个标准：（a）低回声区，（b）与骨骺的距离增加，（c）骨骺脱位，（d）动态检查时骨骺的活动度。这些标准分别与（a）水肿，（b）溶解，（c）撕脱，（d）骨骺不稳定撕脱相关。超声检查是一种已被证实的用于检测骨骺损伤的技术。与X线检查相比，它具有无辐射暴露、即使没有骨化中心也能早期检测以及可进行动态检查等优点。
