低估了所谓的Rockwood II伤害-不要错过横向的不稳定性
Marc Banerjee1,2, Carolin Spüntrup3, Christophe Lambert1
1Klinik für Orthopädie, Unfallchirurgie und Sporttraumatologie Klinikum Köln Merheim, Witten/Herdecke University: Universitat Witten/Herdecke, Köln, GERMANY.
概括
洛克伍德II型关节骨损伤需要对水平不稳定性的评估,而不仅仅是标准的应力放射. 忽视这一点可能会导致洛克伍德IV型受伤或II型受伤不稳定的错误诊断.
科学领域:
- 整形外科手术 整形外科手术
- 运动医学 运动医学
- 放射学 放射学是一门学科.
背景情况:
- 洛克伍德II型关节骨损伤通常是非手术治疗的.
- 这些患者的持续症状可能源于被忽视的水平不稳定性.
- 当前的诊断方法可能无法充分检测这种不稳定性.
研究的目的:
- 调查明显的洛克伍德II型关节骨损伤中水平不稳定的患病率和诊断挑战.
- 突出全面成像对于准确诊断和治疗规划的重要性.
主要方法:
- 13名患者 (2015-2022) 的病例系列,其中包括罗克伍德II型受伤和水平不稳定.
- 纳入标准:心关节关节距离差 ≤25%在应力放射图上,再加上后部脱或动态后部不稳定.
- 排除标准:其他类型的伤害或 II 类型的无水平不稳定性.
主要成果:
- 八名患者有静态的后部脱位 (洛克伍德型IV),五名患者有动态的后部不稳定.
- 所有患者最初都被诊断为罗克伍德II型,仅基于压力放射.
- 诊断不稳定的平均时间为32.4天.
结论:
- 罗克伍德II型损伤的诊断应包括使用先进成像技术对水平不稳定的评估.
- 仅仅依靠双边应力放射能可以导致错误分类和延迟治疗.
- 准确识别水平不稳定性至关重要,以避免忽视洛克伍德类型IV或复杂类型II损伤.
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