Wu Dan,Chen Zhaoqiang,Xiao Hong,et al.Applications and advances of ultrasonography in diagnosing pediatric elbow fractures[J].Journal of Clinical Pediatric Surgery,2025,(12):1196-1200.[doi:10.3760/cma.j.cn101785-202508050-019]
超声检查用于儿童肘关节骨折诊断的研究进展
- Title:
- Applications and advances of ultrasonography in diagnosing pediatric elbow fractures
- Keywords:
- Elbow Joint Fracture; Ultrasonography; Diagnosis; Child
- 摘要:
- 肘关节骨折是儿童常见损伤,由于儿童骨骼系统尚未发育成熟。且骨化中心随年龄增长而变化,传统影像学方法在诊断中存在局限。X线片对于无移位骨折及软骨损伤的敏感性欠佳;CT辐射剂量较高;MRI则因检查时间长、费用高,在急诊和基层应用受限;而超声检查具有无创、无辐射、可实时动态评估及对于软骨、软组织的分辨率高等优势,有望成为儿童肘关节骨折的一线筛查工具。本文综述了超声在儿童肘关节骨折诊断中的应用价值,重点阐述正常儿童肘关节的超声解剖特征,分析其诊断效能,并探讨超声在肱骨髁上骨折、外髁骨折等常见类型肘关节骨折中的具体应用。超声通过识别骨皮质中断等直接征象及脂肪垫移位、关节积液等间接征象,有助于发现隐匿性骨折,减少不必要的辐射暴露,然而其诊断准确性受到操作者经验及骨折复杂程度的影响。未来需推进超声扫描方案标准化与操作规范化培训,并探索人工智能辅助诊断、超声弹性成像及三维超声等新技术,为临床随访与疗效评估提供更精准的影像学依据。
- Abstract:
- Pediatric elbow fractures represent a common type of skeletal injury.However,a definite diagnosis via traditional imaging is frequently constrained by immature state of developing skeleton and individual differences in the appearance and fusion of its ossification centers.Conventional radiographs lack sensitivity for nondisplaced fractures and cartilaginous damage,computed tomography (CT) carries a high radiation burden and magnetic resonance imaging (MRI) remains limited in emergency and primary care settings due to its prohibitive expense and lengthy examination duration.Owing to its noninvasiveness,non-irradiation,real-time dynamic assessment capability and high resolution for cartilage and soft tissues,ultrasonography offers the potential of becoming a first-line screening tool for pediatric elbow fractures.This review systematically examines the value of ultrasound in diagnosing elbow fractures in children,with a particular focus on normal sonographic anatomy,an exploration of its diagnostic performance and extensive applications for such common injuries as supracondylar and lateral condyle fractures.It proved that ultrasound could reliably detect occult fractures through direct signs (cortical discontinuity) and indirect indicators (fat pad sign & joint effusion),thus avoiding unnecessary radiation exposure.Nevertheless,diagnostic accuracy of technique is contingent upon operator expertise and fracture complexity.Ultrasound is an ideal first-line screening modality for pediatric elbow trauma.Future imperatives include standardizing scanning protocols,formalized training for operators and explorations of such novel techniques as artificial intelligence-assisted diagnosis,ultrasonic elastography and three-dimensional ultrasound to offer more precise imaging data for clinical monitoring and assessment of treatment outcomes.
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备注/Memo
收稿日期:2025-8-25。
基金项目:宁波市骨科与运动康复临床医学研究中心(2024L004)
通讯作者:段红波,Email:hongbod919@163.com