摘要
目的探讨超声评估儿童肱骨髁上骨折手术后肱前线(anterior humeral line, AHL)与肱骨小头位置关系的可行性。方法回顾性分析2022年9月至2024年3月期间在华中科技大学同济医学院附属武汉儿童医院接受手术治疗的104例肱骨髁上骨折患儿临床资料。患儿年龄(5.8±2.2)岁, 均在超声引导下接受闭合复位经皮钢针内固定术, 术后通过超声图像和X线侧位片评估AHL与肱骨小头的位置关系。结果超声评估AHL与肱骨小头位置关系的灵敏度为94%, 特异度为81%。在5岁以下和5岁及以上患儿中灵敏度分别为96%和92%, 特异度分别为81%和92%。超声和X线评估AHL与肱骨小头的位置关系一致性较好(Kappa=0.764), 且在不同年龄组之间保持较好一致性。同一医师两次测量的超声和X线检查结果一致性高(超声:Kappa=0.984;X线:Kappa=0.920)。不同医师之间的超声测量结果一致性高(Kappa=0.861), X线检查结果一致性较高(Kappa=0.750)。结论超声与X线在测量AHL与肱骨小头的位置关系方面具有高度一致性, 可作为一种有效的技术用于评估儿童肱骨髁上骨折手术后矢状位复位质量。
Objective To evaluate the feasibility of ultrasound for assessing the postoperative relation-ship between anterior humeral line(AHL)and capitellar ossific nucleus(CON)with supracondylar humeral fracture(SHF)in children.Methods Between September 2022 and March 2024,the relevant clinical data were retrospectively reviewed for 104 SHF children.There was a mean age of(5.8±2.2)year.After ultrasound-guided closed reduction and percutaneous pin fixation,the relationship of AHL and CON was assessed by ultrasound and radiography.Results The sensitivity and specificity of ultrasound in as-sessing the relationship of AHL and CON were 94%and 81%.In children aged under and above 5 year,the sensitivity was 96%and 92%while the specificity 81%and 92%respectively.Ultrasound and radiography demonstrated significant consistency in assessing the relationship of AHL and CON(Kappa=0.764).It remained significant across different genders and age groups.The intra-observer reliability for ultrasound(Kappa=0.984)and radiography(Kappa=0.920)revealed almost perfect consistency.Inter-observer relia-bility also indicated almost perfect consistency for ultrasound(Kappa=0.861)and substantial consistency for radiography(Kappa=0.750).Conclusions Ultrasound and radiography have high consistency in measuring the relationship between AHL and capitellum.Therefore ultrasound may be used for assessing the quality of sagittal planar reduction after surgery for SHF in children.
作者
胡平波
曾凡伦
王腾
李俊
伍兴
沈先涛
Hu Pingbo;Zeng Fanlun;Wang Teng;Li Jun;Wu Xing;Shen Xiantao(School of Medicine,Jianghan University,Wuhan 430056,China;Department of Orthopedics,Wuhan Children’s Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430016,China)
出处
《临床小儿外科杂志》
北大核心
2025年第6期582-586,共5页
Journal of Clinical Pediatric Surgery
基金
湖北省重点研发计划项目(2021BCA140)
湖北省自然科学基金项目(2022CFB460)。
关键词
肱骨髁上骨折
超声检查
手术后期间
肱前线
肱骨小头
儿童
Supracondylar Fracture of Humerus
Ultrasonography
Postoperative Period
Anterior Hu-meral Line
Capitulum of Humerus
Child
