儿童侧位肱骺角的测量及其临床意义

目的 测量儿童侧位肱骺角的正常值,探讨其临床意义.方法 对2～13岁双肘无骨折及畸形的骨骺未闭合的志愿者儿童96人192个肘关节进行研究,其中每个年龄组8人,男、女各4人,共12个年龄组.按不同的年龄段分A(2～5岁)、B(6～9岁)、C(10～13岁)三个组,每组32人64个肘关节.所有儿童均摄标准侧位X线片,取肱骨干长轴与肱骨小头骺板线的夹角为侧位肱骺角.在受试者中随机选取每年龄组4人,男、女各2人,单侧共48个肘关节,分别摄肘关节标准正位X线片和球管与肱骨干长轴呈侧位肱骺角的改良投射正位X线片,比较两者所显示肱骨小头骺板线的清晰率.结果 正常侧位肱骺角平均47.84°±6.69°;不同性别及不同侧别肘关节侧位肱骺角比较,差异均无统计学意义;侧位肱骺角与年龄之间具有显著相关性.改良投射正位X线片肱骨小头骺板线显示的清晰率为100%,而传统垂直投射则为14.58%.结论 儿童健侧的侧位肱骺角可作为患侧的参考指标;球管与肱骨干长轴呈侧位肱骺角的改良投射正位X线片可清晰显示肱骨小头骺板线.

The measurement of humerocondylar angle in sagittal plane and its clinical significance in children

Objective To measure the normal value of humerucondylar angle in sagittal plane,and to explore its clinical significance in children.Methods Ninety-six normal children who were volunteers among 2 to 13 years old and included 8 volunteers for 4 males and females respectively in each age group,a total of 12 age groups,had not abnormality such as fractures,malformation and closure of osteoepiphysis all of their elbows(192 elbows).The subjects were divided into three groups by age,group A(2-5 yeam),group B (6-9 years),group C(10-13 years),and each group had 32 volunteers and 64 elbows.The humerocondylar angle in sagittal plane was measured in the standard lateral X-ray film of all children with meso-line in the long axis of the humeral shaft and the epiphyseal line of the capitulum of humerus.At the same time,the subjects were randomly selected in each age group,4 volunteers,2 males and females respectively,a total of 48 unilateral elbows,which were respectively took the standard anteroposterior plane and the improved anteroposterior plane which the angle of sucker and the long axis of humerus was the humerocondylar angle in sagittal plane,then comparing both clear rate of the epiphyseal line of the capitulum of humerus in anteroposterior plane.Results The average value of humerocondylar angle in sagittal plane was 47.84°±6.69°.There were no significant difference in sexes and sides.However,there was significant correlation between ages and humerocondylar angle in sagittal plane.The clear rate of the epiphyseal line of capitulum of humerus in improved anteropostefior plane was 100%,but the anteroposterior plane of vertical projection of tradition showed a clear rate of 14.58%.Conclusion Humeroeondylar angle of healthy side in sagittal plane could be used as a reference for opposite side in individual supracondylar fractures of humerus.Furthermore,the angle of sucker and the long axis of humerus was the humeroeondylar angle in sagittal plane which could provide a basis for clearly showing the epiphyseal line of capitulum of humerus in improved anteroposterior plane.