Zhou Yijun,Yang Ge,Bai Xiaoan,et al.Comparative study of midpoint line of proxima-distal epiphyseal of radius and traditional radiocapitellar in diagnosis of Monteggia’s fracture in children[J].Journal of Clinical Pediatric Surgery,,22():773-777.[doi:10.3760/cma.j.cn101785-202307046-014]
Comparative study of midpoint line of proxima-distal epiphyseal of radius and traditional radiocapitellar in diagnosis of Monteggia’s fracture in children
- Abstract:
- Objective To seek a novel radiographic diagnostic method for Monteggia fracture in children other than traditional radiocapitellar line (RCL).Methods From April 2020 to January 2023, the relevant clinical data were retrospectively reviewed for 100 hospitalized children suspected with Monteggia fracture at both hospitals.Anteroposterior and lateral radiographs of ulna and radius (including double joints) were examined.And the lesions were confirmed by elbow magnetic resonance imaging (MRI) or arthrography.Traditional RCL (N-line:center line along long axis of radial neck; S-line:Along longitudinal axis of radial shaft) and midpoint line of proximal-distal radial epiphysis (P-line) were drawn on each anteroposterior and lateral radiological films.The accuracy of RCL and P line in the diagnosis of Monteggia fracture was compared.Results When P-line was compared with the gold standard, the number of true positive cases was 78, the number of false positive cases 0, the number of true negative cases 16 and the number of false negative cases 6.The diagnostic coincidence rate of P line was 94%(94/100), the diagnostic omission rate 7.14%(6/84) and the misdiagnosis rate 0.When N-line was compared with the gold standard, the number of true positive cases was 82, the number of false positive cases 16, the number of true negative cases 0 and the number of false negative cases 2.The diagnostic coincidence rate of N-line was 82%(82/100), the diagnostic omission rate 2.38%(2/84) and the misdiagnostic rate 100.00%(16/16).When S-line was compared with the gold standard, the number of true positive cases was 54, the number of false positive cases 0, the number of true negative cases 16 and and the number of false negative cases 30.The diagnostic coincidence rate of S line was 70%(70/100), diagnostic omission rate 35.71%(30/84) and misdiagnostic rate 0.Diagnostic Kappa value of P line was 0.806, N-line -0.037 and S line 0.365.Conclusion The value of P line is more reliable than N/S line in the initial radiographic diagnosis of Monteggia fracture.
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Memo
收稿日期:2022-07-24。
基金项目:湖南儿科医联体专项科研基金（2021hnekyltB04）
通讯作者:梅海波,Email:meihaibo@sohu.com