度怀疑Ⅴ型损伤者，可行MRI检查，了解软骨的压缩或其他损伤情况。 五、 骺板损伤的并发症及预后：[17-20] 在上肢，Salter-Harris 1~3型预后较好，4型应高度警惕，5型预后差；相对而言，下肢由于承重，其骨骺损伤并发症较上肢发生率高，且预后与Salter-Harris分型无明显关系，主要与受损部位及程度有关，畸形主要为成角与短缩。年龄也是影响预后的重要因素，显然，在即将闭和的骺板处出现骨桥其临床意义不大。对于X线检查阴性而临床高度怀疑骺板损伤的患者应进行MRI检查以明确诊断，对于明确骨骺损伤的患者临床及影像随访十分重要，每3~6月进行双侧对称肢体的X线检查，连续随访至少2年是十分必要的，此举有助于早期发现骺早闭并判定骨骺损伤后短缩或成角畸形
发生的程度，指导临床进行必要的干预。 参考文献 1. Simon C. S. Kao, Wilbur L. Smith, Skeletal injuries in the Pediatric patient. Radiologic Clinics of North America., 1997;35(3):727-746 2. Makela EA, Vainionpaa S, Vihtonen K, etal: The effict of trauma to the
lower femoral epiphyseal plate: an experimental study in rabbits. J Bone Joint Surg. 1988;70:187-191 3. Smith DG, Geist RW, Cooperman DR: Microscopic
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12. Carey J; Spence L; Blickman H; MRI of pediatric growth plate injury: correlation with plain film radiographs and clinical outcome. Skeletal Radiol 1998 May;27(5):250-5 13. Naranja RJ Jr; Gregg JR; Dormans JP; Pediatric fracture without radiographic abnormality. Description and significance. Clin Orthop 1997 Sep;(342):141-6 14. Borsa JJ, Peterson HA, Ehman RL; MR imaging of phuseal bars. Radiology, 1996;199:683-687 15. Davidson RS, Markowitz RI, Dormans J, etal;
Ultrasonographic evaluation of the elbow in infants and young children after suspected trauma. J Bone Joint Surg. 1994;76:1804-1813 16. Smith BG, Rand F, Jaramillo D, et al; Early MR imaging of lower extremity physeal fracture –separatons: a preliminary report. J Pediatr Orthop, 1994;14:526-533 17. Carlson WO, WengerDR: A mapping method to prepare for surgical excision of partial physeal arrest. J Pediatr Othrop, 1984; 4:232-238 18. Rogers LR, Poznanski AK; Imaging of epiphyseal injuries. Radioloyg, 1994; 191:297-308 19. Classification of epiphyseal injury. J Pediatr Orthop, 1994;14:439-448 20. Diego Jaramillo, Fredric AH, Frederic Shapiro; MR imaging of fractures of the growth plate. AJR, 1990;155:1261-1265
儿童骺软骨骨折的影像诊断
