腕关节损伤与常用诊断标准的对照研究(附300例测量分析)

目的：通过测量分析，研究腕关节损伤和常用诊断标准在Ｘ线诊断中的应用价值，提高腕关节损伤诊断的准确性。方法：详细测量分析我院有探讨价值的资料３００份，用三条弧线，腕关节方框，侧位轴线，舟月角，舟骨环征，腕高率，腕尺距进行详细分析。结果：腕骨损伤１９４例。腕骨脱位１０６例。在常用诊断标准中三条弧线：对舟骨骨折成角型，移位型，翻转型，三角骨横折型，纵折型骨折。经舟骨月骨周围腕脱位，月骨周围腕脱位，月骨掌侧脱位中的诊断价值极高，阳性率为１００％。腕关节方框：对移位型舟骨骨折阳性率为２７％，三角骨横行骨折阳性率为３６％，经舟骨月骨周围腕脱位阳性率为２０％。侧位轴线：对经舟骨月骨周围腕脱位，月骨周围腕脱位，月骨掌侧脱位阳性率为１００％，对舟骨骨折移位型阳性率为３６％。舟月角：仅对舟骨骨折翻转型和常见腕骨脱位有诊断价值。腕高率、腕尺距仅在腕骨结构紊乱中有较高的诊断价值。另外，舟骨环征仅是一个征象，不是一个诊断标准。结论：七条诊断标准对常见的舟骨稳定型和三角骨背、掌侧型骨折均无特异性改变。在腕骨损伤中三条弧线的诊断价值极高，侧位轴线次之。

The Comparative Study of Diagnostic Criterions in Wrist Trauma(An Analysis of 300 Cases)

Objective: To study the practic value of X-ray diagnosis of wrist trauma with diagnostic criterions in order to improve the diagnostic rate of injuried wrist. Methods: The measurement of wrist trauma in 300 cases was analysed.These contained three curve line,square frame of wrist,laterial axis,angle of scaphoid and lunare bone,ring-like sign of scaphoid,carpal height ratio,distance of carpal and ulna. Results: There were carpal bone trauma in 194 cases and carpal dislocation in 106 cases.The three curve line in diagnostic criterions used in wrist,the postitive diagnostic rate as followed:in angular type and reverse type of scaphoid fracture;transverse type,longitudinal type of triquetrum,peri-lunare disocation per scaphoid,peri-lunare dislocation of carpal was 100%,Wrist square frame:in dislocated scaphoid fracuture was 27%,in transverse fracture of triquetrum was 36% and in peri-lunare dislocation was 20%.Longitudinal axis:in peri-lunare dislocation per-scaphoid,peri-lunare dislocation and palm side lunare dislocation was 100%,in the position moving type of scaphoid fracture was 36%.Scaphoid-lunare angle:there was diagnostic value only in reverse scaphoid fracture and wrist dislocation.Carpal height ratio and carpal ulna distance:had higher diagnostic value in structure confusion of carpal.Ringlike sign was only a sign not a diagnostic criterion. Conclusion: Seven diagnostic criterions for scaphoid fracture and fracture of triqutrum have no specific change in wrist trauma,while three curve line and longitudinal axis have highest diagnostic value.