青少年胫骨结节骨折的MRI表现及相关损伤：一项回顾性研究

IF 2 3区医学 Q3 CRITICAL CARE MEDICINE

Injury-International Journal of the Care of the Injured Pub Date : 2025-09-18 DOI:10.1016/j.injury.2025.112765

Xinwei Li , Lu Zhang , Taotao Hui , Zhongli Zhang , Weifeng Lin

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引用次数: 0

摘要

目的胫骨结节骨折是一种罕见的青少年骨性损伤，尽管其伴随软组织损伤的风险很高，但在x线片上却经常被忽视。本研究分析63例磁共振成像（MRI）表现及并发损伤，以提高诊断准确性，指导临床处理。本研究旨在探讨青少年胫骨结节骨折的MRI特征和相关损伤模式。方法对2017年6月至2025年1月我院收治的63例青少年胫骨结节骨折患者进行回顾性分析。该队列包括62名男性和1名女性，年龄从11岁到16岁（平均13.9岁）。右侧骨折22例，左侧骨折40例，双侧骨折1例。身体质量指数（BMI）从20.8到33.3 kg/m²不等，平均值为26.8 kg/m²。入院后，所有患者在48小时内进行MRI检查（3.0 T，包括T1-、T2-和stir加权序列）。骨折类型根据Ogden分类进行分类，同时记录韧带和半月板相关损伤。结果所有患者均有髌骨肌腱损伤（6例髌骨肌腱断裂）。相关损伤包括前交叉韧带损伤28例（44.4%），后交叉韧带损伤3例（4.8%）。半月板损伤25例（39.7%），其中ⅰ级9例，ⅱ级12例，ⅲ级4例。髌骨周围支持带损伤28例（44.4%），膝内侧或外侧副韧带损伤13例（20.6%）。伴发腓骨骨折1例（1.6%），髌骨骨折10例（15.9%），髌骨半脱位5例（7.9%）。结论x线平片是诊断青少年胫骨结节骨折的首选影像学方式，而CT对骨折类型的进一步分类有重要意义。在怀疑伴有软组织损伤的情况下，如涉及髌骨韧带或半月板的软组织损伤，MRI提供了重要的诊断价值，并在手术计划和并发症预防中起着至关重要的作用。证据等级：III级。

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MRI manifestations and associated injuries in adolescent tibial tuberosity fractures: A retrospective study

Purpose

Tibial tuberosity fractures are rare physeal injuries in adolescents and are frequently overlooked on radiographs, despite a high risk of associated soft tissue injury. This study analyzed magnetic resonance imaging (MRI) findings and concurrent injuries in 63 cases to improve diagnostic accuracy and guide clinical management. This study aimed to investigate the MRI features and associated injury patterns of tibial tuberosity fractures in adolescents.

Methods

A retrospective analysis was performed on 63 adolescent patients with tibial tuberosity fractures admitted to our hospital between June 2017 and January 2025. The cohort comprised 62 males and 1 female, with ages ranging from 11 to 16 years (mean: 13.9 years). Fractures occurred on the right side in 22 cases, the left side in 40 cases, and bilaterally in 1 case. Body mass index (BMI) ranged from 20.8 to 33.3 kg/m², with a mean of 26.8 kg/m². Upon admission, all patients underwent MRI examinations within 48 h (3.0 T, including T1-, T2-, and STIR-weighted sequences). Fracture types were classified according to the Ogden classification, and associated injuries involving ligaments and the meniscus were simultaneously documented.

Results

MRI revealed patellar tendon injuries in all patients (patellar tendon rupture in 6 cases). Associated injuries included anterior cruciate ligament (ACL) injuries in 28 cases (44.4 %) and posterior cruciate ligament (PCL) injuries in 3 cases (4.8 %). Meniscal injuries were observed in 25 cases (39.7 %), comprising 9 cases of grade I, 12 cases of grade II, and 4 cases of grade III. Peripatellar retinacular injuries were present in 28 cases (44.4 %), and medial or lateral collateral ligament injuries of the knee were identified in 13 cases (20.6 %). Additional associated injuries included 1 case (1.6 %) of fibular fracture, 10 cases (15.9 %) of patellar fracture, and 5 cases (7.9 %) of patellar subluxation.

Conclusion

Plain radiography is the preferred imaging modality for diagnosing tibial tuberosity fractures in adolescents, while computed tomography (CT) can be useful for further classification of fracture types. In cases where concomitant soft tissue injuries—such as those involving the patellar ligament or meniscus—are suspected, MRI provides significant diagnostic value and plays a crucial role in surgical planning and complication prevention.

Level of Evidence

Level III.

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来源期刊

Injury-International Journal of the Care of the Injured 医学-急救医学

CiteScore

4.00

自引率

8.00%

发文量

699

审稿时长

96 days

期刊介绍： Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.