成人外伤性肘部脂肪垫征与桡骨头骨折的相关性研究

目的:探讨外伤性肘关节脂肪垫征与桡骨头骨折的相关性。方法:从96例病例中收集46例肘关节外伤后肘关节脂肪垫征阳性患者的CR、CT及临床资料。按临床最终诊断有无桡骨头骨折分为病例组(25例)和对照组(21例)。病例组均为单纯性桡骨头骨折病例,按桡骨头骨折Mason分型分为"Ⅰ型组"(15例)和"其他类型组"(10例)。分别测量两组病例的肘前脂肪垫(anterior fat pad,AFP)和肘后脂肪垫(posterior fat pad,PFP)的最大厚度,并进行统计学分析。结果:病例组AFP、PFP厚度分别为(12.40±1.80)mm、(10.10±2.47)mm,对照组分别为(5.36±1.54)mm、(4.08±0.92)mm,两组间AFP和PFP厚度有显著性差异(P<0.01);桡骨头骨折MasonⅠ型组AFP、PFP厚度分别为(12.38±1.44)mm、(5.66±1.56)mm,其他类型组分别为(12.42±3.32)mm、(4.90±1.48)mm,两组间AFP和PFP厚度差异无统计学意义(P>0.05);AFP、PFP厚度对桡骨头骨折诊断的准确度A分别为0.775、0.757时具有一定的准确性(P<0.05),两指标A的95%CI分别为(0.641⁰.910)、(0.6180.910)、(0.618⁰.896)。结论:外伤性脂肪垫征与桡骨头骨折存在一定的相关性,肘部脂肪垫厚度值越大桡骨头骨折的可能性愈大;但脂肪垫的厚度对区分桡骨头骨折类型无指导价值。

Correlation between Traumatic Fat Pad Sign and Radial Head Fracture in Adult

Objective To explore the correlation between traumatic fat pad sign and radial head fracture in adults. Methods The CR,CT and clinical data of 46 cases with positive fat pad sign were collected from 96 patients with elbow joint trauma.The 46 cases were divided into cases group（ n = 25） and control group（ n = 21） according to the clinical final diagnosis of with or without fracture at radial head. The patients in cases group,which were diagnosed with simple fracture,were divided into type Ⅰ subgroup（ n = 15） and other types subgroup（ n = 10） according to Mason classification. The maximum thickness of anterior fat pad（ AFP） and posterior fat pad（ PFP） were measured and statistically analyzed. Results The thickness of AFP and PFP in cases group were（ 12. 40 ± 1. 80） mm and（ 10. 10 ± 2. 47） mm,while the thickness of AFP and PFP in control group were（ 5. 36 ± 1. 54） mm and（ 4. 08 ± 0. 92） mm,respectively. The thickness of AFP and PFP were obvious difference between two groups（ P〈 0. 01）. The thickness of AFP and PFP of type Ⅰ subgroup were（ 12. 38 ± 1. 44） mm and（ 5. 66 ± 1. 56） mm,while the thickness of AFP and PFP of other types subgroup were（ 12. 42 ± 3. 32） mm and（ 4. 90± 1. 48） mm,respectively. The thickness of AFP and PFP had no significant difference between two subgroups（ P〉0. 05）.According to the ROC curve analysis,the accuracy A of diagnosis of radial head fracture were 0. 775,0. 757（ P〈0. 05）,and 95% CI of the above two A were（ 0. 641 - 0. 910）,（ 0. 618 - 0. 896）. Conclusion The sign of traumatic fat pad sign may correlate with radial head fractures in adults,the thicker of the elbow fat pad was more beneficial to the diagnosis of radial head fractures,however the changes of the elbow fat pad did not provide valuable help for distinguish the type of radial head fractures.