【摘要】 目的 比较超声与X线检查在诊断儿童四肢长骨青枝骨折中的应用价值。方法 收集临床高度怀疑四肢长骨青枝骨折，初诊均行超声和X线检查的患儿60例(70处)。并于2周后复查X线，失访9例(10处),资料完整51例(60处)。其中男35例(42处)、女16例(18处),平均年龄6岁，发生部位桡骨25处、肱骨14处、尺骨12处、胫骨4处、腓骨3处、指骨1处、趾骨1处。比较初次超声与X线的检出率。结果 超声诊断的准确度高于X线[95.0%(57/60)vs. 75.0%(45/60),P<0.05]。超声灵敏度为97.7%,特异度为87.5%,受试者工作特征(ROC)曲线下面积为0.926,P<0.001;X线灵敏度为68.2%,特异度为93.7%,ROC曲线下面积为0.810,P<0.001。结论 超声可作为X线未检出的儿童四肢长骨青枝骨折的补充性检查手段，能进一步提高诊断率，减少漏诊误诊。更多还原

【Abstract】 Objective To compare the application value of ultrasound and X-ray in the diagnosis of long bone green branch fracture in children. Methods A total of 60(70 bones)cases of children with high clinical suspicion of limbs long bone green branch fracture were collected. Ultrasound and X-ray examinations were performed for the first time, and X-ray examinations were performed 2 weeks later, with complete data in 60 cases, lost follow-up in 9(10 bones) cases. Among them, 35(42 bones) were males and 16(18 bones) were females, with an average age of 6 years. The fractures occurred in 25 radials, 14 humerus, 12 ulnas, 4 tibias, 3 fibulas, 1 phalanges of hands and 1 phalanges of foot. The detection rate of initial ultrasound and X-ray was compared. Results The diagnosis accuracy of ultrasound and X-ray were 95.0%(57/60) and 75.0%(45/60) respectively(P<0.05). The sensitivity and specificity of ultrasound were 97.7%, and 87.5%. The area under the receiver operating characteristic(ROC) curve was 0.926(P<0.001); The sensitivity and specificity of X-ray were 68.2% and 93.7%. The area under the ROC curve was 0.810(P<0.001). Conclusions Ultrasound is a reliable method to diagnose green branch fractures of limbs in children. When X-ray is negative but the green branch fractures are highly suspected, ultrasound can improve the diagnosis rate and reduce missed diagnosis and misdiagnosis.更多还原