Abstract
BackgroundHumeral lateral condyle fractures (HLCFs) are common paediatric fractures. Radiographs are hard to accurately evaluate and diagnose the damage of articular epiphyseal cartilage in HLCFs.Methods60 children who should be suspected to be HLCFs in clinical practice from Dec 2015 to Nov 2017 were continuously included as the first part patients. Subsequently, 35 HLCFs patients with complete follow-up information who had no obvious displacement on radiograph were the second part patients. The sensitivity and specificity of radiograph and MRI in diagnosing of HLCFs and their stability were calculated respectively. Calculated the sensitivity and specificity of each scan sequence of MRI in diagnosing of HLCFs osteochondral fractures. The degree of fracture displacement was measured respectively. Compared the ratio of surgical treatment, secondary fracture displacement and complications between the stable fracture group and the unstable fracture group on MRI in part 2 patients.ResultsSensitivity of diagnosing HLCFs by MRI was significantly higher than radiograph (100.00% vs. 89.09%, P = 0.03). Sensitivity of diagnosing integrity of trochlear cartilage chain by MRI was 96.30%, which was significantly higher than that by radiograph (62.96%, P < 0.01). The sensitivity of cartilage sensitive sequence (3D-FS-FSPGR/3D-FSPGR) was different with FS-PDWI and FS-T2WI (P = 0.01 and P = 0.02, respectively). The degree of HLCFs displacement by MRI was higher than radiograph (P < 0.05). In the unstable fracture group, 5 cases (45.45%) had a fracture displacement of more than 2 mm on MRI, which was significantly higher than that in stable fracture group (0.00%, P < 0.01).ConclusionsMRI is superior to the radiograph of elbow joint in evaluating and diagnosing children HLCFs and their stability. The coronal 3D-FS-FSPGR/3D-FSPGR sequence is a significant sequence for diagnosing osteochondral fractures in HLCFs. MRI can provide important clinical value for treatment decisions of HLCFs without significant displacement.
Highlights
Humeral lateral condyle fractures (HLCFs) are common paediatric fractures
Patients The patients in this study were divided into two parts. 60 children with acute elbow joint injuries admitted to the department of orthopedics and pediatrics or emergency department who should be suspected to be HLCFs in clinical practice were included from Dec 2015 to Nov 2017 as the first part patients
The exclusion criteria were as follows: (1) Age > 14 years; (2) Those diagnosed with other types of elbow injuries such as supracondylar fractures of the humerus; (3) Patients with incomplete or missing medical records/imaging materials; (4) Patients who lost to follow-up; (5) Patients were unable to be diagnosed or accurately measured the degree of fracture displacement by MRI due to non-cooperation; (6) Patients with pathological fractures of the elbow joints or combined infections or tumorous lesions
Summary
Radiographs are hard to accurately evaluate and diagnose the damage of articular epiphyseal cartilage in HLCFs. Humeral lateral condyle fractures (HLCFs) are common paediatric fractures. Qi et al J Orthop Surg Res (2021) 16:617 radiographs, and it is not difficult to identify the fracture line in the HLCFs. because the distal humerus epiphysis in children has not yet been fully ossified, radiographs are hard to accurately evaluate and diagnose the damage of articular epiphyseal cartilage, especially in HLCFs without displacement or with micro displacement. Because the distal humerus epiphysis in children has not yet been fully ossified, radiographs are hard to accurately evaluate and diagnose the damage of articular epiphyseal cartilage, especially in HLCFs without displacement or with micro displacement It still a big challenge for orthopedic pediatricians and radiologists. We aimed to investigate: (1) The differences between radiograph and MRI in diagnosing of HLCFs and the integrity of the cartilage chain of the humerus trochlear, and the best MRI sequence to diagnosis HLCFs; (2) The differences in evaluating the degree of fracture displacement in children with HLCFs between radiograph and MRI; (3) The clinical value of MRI in the diagnosis of HLCFs in children without significant displacement
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