Objective To investigate the clinical diagnostic value of musculoskeletal ultrasound in children with closed distal tibia and fibula fractures.Methods Eighty children with acute ankle joint trauma admitted to General Hospital of Southern Theatre Command of PLA from March 2021 to May 2023 were prospectiveiy seleted as the observation objects.Musculoskeletal ultrasound,X-ray examination and multi-slice spiral CT examination were performed in all children,and the results of multi-slice spiral CT examination were taken as the reference standard for clinical diagnosis.The diagnostic effect of musculoskeletal ultrasonography,X-ray and combined examination in distal tibia-fibula fractures,fracture types,fracture types were analyzed and compared,and direct findings of musculoskeletal ultrasound in closed distal tibiofibular fractures in children had been summarized.Results Among the 80 children with acute ankle joint trauma,according to the diagnosis of multislice spiral CT,67 cases were diagnosed with closed distal tibia-fibular fracture epiphysis injury and 13 cases were non-epiphysis injury.The results of com-bined examination and multi-slice spiral CT were consistent(Kappa=1.000).The results of musculoskeletal ultrasonography were consistent with those of multi-slice spiral CT(Kappa=0.932).The results of X-ray examination were generally consistent with those of multi-slice spi-ral CT(Kappa=0.501).The diagnostic efficiency of combined examination was obviously the best,but the sensitivity and accuracy of musculo-skeletal ultrasonography in single examination were better than that of X-ray examination.Further diagnosis of fracture types was carried out in 67 children with confirmed closed distal tibia and fibula fractures.Musculoskeletal ultrasound detected all fractures,but there was misdiagnosis in 1 case and X-ray examination in 17 cases.The accuracy of musculoskeletal ultrasound was significantly higher than X-ray examination,the differ-ence was statistically significant(P＜0.05).Sixty-seven cases of closed distal tibia and fibula fractures were diagnosed according to Salter-Harris classification,and there was no statistical difference between musculobone ultrasound and X-ray in classification diagnosis(P＞0.05).Musculoskeletal ultrasound directly showed:widening of epiphyseal plate,interruption of continuous cortical bone,slight separation and displace-ment of fracture end,infiltration of fluid or hematoma in slightly wider fracture line,edema of surrounding tissue,and thickening of synovial mem-brane.Conclusion Compared with X-ray examination,musculoskeletal ultrasound has higher diagnostic efficacy,but the combination of the two has the best effect,and musculoskeletal ultrasound has superior effect in the diagnosis of fracture types,and can be used as the first choice for screening children with closed distal tibia and fibula fractures,but it can only be used as an auxiliary means in distinguishing fracture types.
维普
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