surgumedВестник СурГУ. МедицинаVestnik SurGU. Meditsina2949-3447Сургутский государственный университет10.35266/2949-3447-2024-2-3surgumed-741Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНА. ОРИГИНАЛЬНОЕ ИССЛЕДОВАНИЕCLINICAL MEDICINE. ORIGINAL RESEARCHВОПРОСЫ ДИАГНОСТИКИ ТРАВМЫ ЛОКТЕВОГО СУСТАВА У ДЕТЕЙDIAGNOSTIC ISSUES OF ELBOW JOINT INJURY IN CHILDRENhttps://orcid.org/0009-0006-1319-3480СавицкаяА. Н.SavitskayaA. N.

врач-рентгенолог

Radiologist

savitskayaan@zdrav.mos.ruhttps://orcid.org/0000-0002-3235-8854АхадовТ. А.AkhadovT. A.

доктор медицинских наук, профессор, заслуженный врач РФ, заслуженный деятель науки РФ, руководитель отдела лучевых методов диагностики

Doctor of Sciences (Medicine), Professor, Honored Doctor of the Russian Federation, Honored Scientist of the Russian Federation, Head of Radiology Department

https://orcid.org/0000-0001-6411-0709МитишВ. А.MitishV. A.

кандидат медицинских наук, врач-хирург

Candidate of Sciences (Medicine), Surgeon

https://orcid.org/0000-0002-2910-3711МельниковИ. А.MelnikovI. A.

кандидат медицинских наук, заведующий отделением КТ-МРТ диагностики

Candidate of Sciences (Medicine), Head of CT-MRI Department

https://orcid.org/0000-0002-4709-9461БожкоО. В.BozhkoO. V.

кандидат медицинских наук, ведущий научный сотрудник

Candidate of Sciences (Medicine), Leading Researcher

https://orcid.org/0000-0002-4627-9874УблинскийМ. В.UblinskyM. V.

кандидат биологических наук, старший научный сотрудник

Candidate of Sciences (Biology), Senior Researcher

https://orcid.org/0000-0003-1260-4509ДмитренкоД. М.DmitrenkoD. M.

заведующий отделением рентгенодиагностики

Head of Radiation Therapy Department

https://orcid.org/0000-0002-2527-2956СероваН. Ю.SerovaN. Yu.

врач-травматолог

Traumatologist

Научно-исследовательский институт неотложной детской хирургии и травматологии, МоскваРоссияClinical and Research Institute of Emergency Pediatric Surgery and Traumatology, MoscowRussian FederationНаучно-исследовательский институт неотложной детской хирургии и травматологии; Национальный медицинский исследовательский центр хирургии имени А. В. Вишневского, МоскваРоссияClinical and Research Institute of Emergency Pediatric Surgery and Traumatology; National Medical Research Center of Surgery named after A. Vishnevsky, MoscowRussian Federation2024040720241722633Copyright © Савицкая А.Н., Ахадов Т.А., Митиш В.А., Мельников И.А., Божко О.В., Ублинский М.В., Дмитренко Д.М., Серова Н.Ю., 20242024Савицкая А.Н., Ахадов Т.А., Митиш В.А., Мельников И.А., Божко О.В., Ублинский М.В., Дмитренко Д.М., Серова Н.Ю.Savitskaya A.N., Akhadov T.A., Mitish V.A., Melnikov I.A., Bozhko O.V., Ublinsky M.V., Dmitrenko D.M., Serova N.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surgumed.ru/jour/article/view/741

Представлен анализ результатов за 2022 г. использования в условиях неотложной амбулаторной и стационарной помощи различных методов лучевой диагностики травм локтя у 878 детей от 1 года до 17 лет (7,2 + 3,9). По результатам рентгенографии, в сумме переломы кости составили: плечевой – 63,58 %, лучевой – 14,2 %, локтевой – 12,3 %, а по данным компьютерной томографии, переломы кости: плечевой – 39,65 %, локтевой – 36,68 %, лучевой – 23,73 %. Магнитно-резонансная томография выявила повреждение связок и мышц во всех случаях. Оценка повреждений локтевого сустава всегда должна начинаться с обычной прямой и боковой рентгенографии и использованием дополнительных методов, если диагноз вызывает сомнения. Компьютерную томографию целесообразно использовать для получения детальной картины оскольчатых и внутрисуставных переломов и для планирования хирургического вмешательства. Магнитно-резонансная томография показана для оценки повреждений мягких тканей, наличия вне- и внутрисуставных свободных костно-хрящевых тел, при подозрении на скрытые переломы.

The study examines the findings of applying various methods of radiation therapy in emergency outpatient and inpatient care of elbow injuries in 878 children aged 12 months to seventeen years (7.2 + 3.9) in 2022. According to radiography findings, bone fractures included a total of 63.58 % of the humerus, 14.2 % of the radius, and 12.3 % of the ulna. According to computed tomography, bone fractures comprised 39.65 % of the humerus, 36.68 % of the radius, and 23.73 % of the ulna. Magnetic resonance imaging revealed ligament and muscle damage in all cases. The evaluation of elbow injuries should always begin with conventional anteroposterior and lateral views and other additional methods if the diagnosis is in doubt. Computed tomography is advised for obtaining a detailed image of comminuted and intraarticular fractures and when planning surgery. Magnetic resonance imaging is used to evaluate soft tissue injuries, detect extra-and intraarticular loose osteocartilaginous bodies, as well as in cases of suspected hidden fractures.

локтевой суставдетитравмарентгенографиякомпьютерная томографиямагнитно-резонансная томографияelbow jointchildrentraumaradiographycomputed tomographymagnetic resonance imagingReferencesPatel D. R., Yamasaki A., Brown K. Epidemiology of sports-related musculoskeletal injuries in young athletes in United States // Translational Pediatrics. 2017. Vol. 6, no. 3. P. 160–166.Patel D. R., Yamasaki A., Brown K. Epidemiology of sports-related musculoskeletal injuries in young athletes in United States // Translational Pediatrics. 2017. Vol. 6, no. 3. P. 160–166.Gupta G., Makadia A. S., Shah M. M. An unreported variant of convergent dislocation of elbow // Journal of Orthopaedic Case Reports. 2018. Vol. 8, no. 6. P. 79–81.Gupta G., Makadia A. S., Shah M. M. An unreported variant of convergent dislocation of elbow // Journal of Orthopaedic Case Reports. 2018. Vol. 8, no. 6. P. 79–81.Kim H. H., Gauguet J. M. Pediatric elbow injuries // Seminars in Ultrasound, CT, and MR. 2018. Vol. 39, no. 4. P. 384–396.Kim H. H., Gauguet J. M. Pediatric elbow injuries // Seminars in Ultrasound, CT, and MR. 2018. Vol. 39, no. 4. P. 384–396.DeFroda S. F., Goodman A. D., Gil J. A. et al. Epidemiology of elbow ulnar collateral ligament injuries among baseball players: National collegiate athletic association injury surveillance program, 2009–2010 through 2013–2014 // The American Journal of Sports Medicine. 2018. Vol. 46, no. 9. P. 2142–2147.DeFroda S. F., Goodman A. D., Gil J. A. et al. Epidemiology of elbow ulnar collateral ligament injuries among baseball players: National collegiate athletic association injury surveillance program, 2009–2010 through 2013–2014 // The American Journal of Sports Medicine. 2018. Vol. 46, no. 9. P. 2142–2147.Dizdarevic I., Low S., Currie D. W. et al. Epidemiology of elbow dislocations in high school athletes // The American Journal of Sports Medicine. 2016. Vol. 44, no. 1. P. 202–208.Dizdarevic I., Low S., Currie D. W. et al. Epidemiology of elbow dislocations in high school athletes // The American Journal of Sports Medicine. 2016. Vol. 44, no. 1. P. 202–208.Owoeye O. B. A., Ghali B., Befus K. et al. Epidemiology of all-complaint injuries in youth basketball // Scandinavian Journal of Medicine & Science in Sports. 2020. Vol. 30, no. 12. P. 2466–2476.Owoeye O. B. A., Ghali B., Befus K. et al. Epidemiology of all-complaint injuries in youth basketball // Scandinavian Journal of Medicine & Science in Sports. 2020. Vol. 30, no. 12. P. 2466–2476.Nakamura K., Hirachi K., Uchiyama S. et al. Long-term clinical and radiographic outcomes after open reduction for missed Monteggia fracture-dislocations in children // The Journal of Bone and Joint Surgery. American Volume. 2009. Vol. 91, no. 6. P. 1394–404.Nakamura K., Hirachi K., Uchiyama S. et al. Long-term clinical and radiographic outcomes after open reduction for missed Monteggia fracture-dislocations in children // The Journal of Bone and Joint Surgery. American Volume. 2009. Vol. 91, no. 6. P. 1394–404.Королева Н. Ю. Эхографическое исследование локтевого сустава у детей в норме и при травматических повреждениях. Литературный обзор // Вестник Российского научного центра рентгенорадиологии. 2010. № 10–1. URL: https://elibrary.ru/download/elibrary_15533138_95073678.pdf (дата обращения: 20.04.2024).Королева Н. Ю. Эхографическое исследование локтевого сустава у детей в норме и при травматических повреждениях. Литературный обзор // Вестник Российского научного центра рентгенорадиологии. 2010. № 10–1. URL: https://elibrary.ru/download/elibrary_15533138_95073678.pdf (дата обращения: 20.04.2024).Bucknor M. D., Stevens K. J., Steinbach L. S. Elbow imaging in sport: Sports imaging series // Radiology. 2016. Vol. 279, no. 1. P. 12–28.Bucknor M. D., Stevens K. J., Steinbach L. S. Elbow imaging in sport: Sports imaging series // Radiology. 2016. Vol. 279, no. 1. P. 12–28.Konda S. R., Goch A. M., Leucht P. et al. The use of ultra-low-dose CT scans for the evaluation of limb fractures: Is the reduced effective dose using CT in orthopaedic injury (REDUCTION) protocol effective? // The Bone & Joint Journal. 2016. Vol. 98-B, no. 12. P. 1668–1673.Konda S. R., Goch A. M., Leucht P. et al. The use of ultra-low-dose CT scans for the evaluation of limb fractures: Is the reduced effective dose using CT in orthopaedic injury (REDUCTION) protocol effective? // The Bone & Joint Journal. 2016. Vol. 98-B, no. 12. P. 1668–1673.Bazzocchi A., Aparisi Gómez M. P., Bartoloni A. et al. Emergency and trauma of the elbow // Seminars in Musculoskeletal Radiology. 2017. Vol. 21, no. 3. P. 257–281.Bazzocchi A., Aparisi Gómez M. P., Bartoloni A. et al. Emergency and trauma of the elbow // Seminars in Musculoskeletal Radiology. 2017. Vol. 21, no. 3. P. 257–281.Del Grande F., Aro M., Farahani S. J. et al. Three-Tesla MR imaging of the elbow in non-symptomatic professional baseball pitchers // Skeletalal Radiology. 2015. Vol. 44. P. 115–123.Del Grande F., Aro M., Farahani S. J. et al. Three-Tesla MR imaging of the elbow in non-symptomatic professional baseball pitchers // Skeletalal Radiology. 2015. Vol. 44. P. 115–123.Chin T. Y., Chou H., Peh W. C. G. The acutely injured elbow // Radiologic Clinics of North America. 2019. Vol. 57, no. 5. P. 911–930.Chin T. Y., Chou H., Peh W. C. G. The acutely injured elbow // Radiologic Clinics of North America. 2019. Vol. 57, no. 5. P. 911–930.Burnier M., Barlow J. D., Sanchez-Sotelo J. Shoulder and elbow fractures in athletes // Current Reviews in Musculoskeletal Medicine. 2019. Vol. 12. P. 13–23.Burnier M., Barlow J. D., Sanchez-Sotelo J. Shoulder and elbow fractures in athletes // Current Reviews in Musculoskeletal Medicine. 2019. Vol. 12. P. 13–23.Saeed W., Waseem M. Elbow fractures overview // StatPearls. Treasure Island (FL) : StatPearls Publishing, 2023. URL: https://europepmc.org/article/nbk/nbk441976 (дата обращения: 20.04.2024).Saeed W., Waseem M. Elbow fractures overview // StatPearls. Treasure Island (FL) : StatPearls Publishing, 2023. URL: https://europepmc.org/article/nbk/nbk441976 (дата обращения: 20.04.2024).Griffith J. F., Roebuck D. J., Cheng J. C. et al. Acute elbow trauma in children: Spectrum of injury revealed by MR imaging not apparent on radiographs // American Journal of Roentgenology. 2001. Vol. 176, no. 1. P. 53–60.Griffith J. F., Roebuck D. J., Cheng J. C. et al. Acute elbow trauma in children: Spectrum of injury revealed by MR imaging not apparent on radiographs // American Journal of Roentgenology. 2001. Vol. 176, no. 1. P. 53–60.Nishijima D. K., Mills T. J., Goldman M. Elbow fracture in the ED. 2021. URL: https://emedicine.medscape.com/article/824654-overview?form=fpf (дата обращения: 20.04.2024).Nishijima D. K., Mills T. J., Goldman M. Elbow fracture in the ED. 2021. URL: https://emedicine.medscape.com/article/824654-overview?form=fpf (дата обращения: 20.04.2024).Gustas C. N., Lee K. S. Multimodality imaging of the painful elbow: Current imaging concepts and image-guided treatments for the injured thrower’s elbow // Radiologic Clinics of North America. 2016. Vol. 54, no. 5. P. 817–839.Gustas C. N., Lee K. S. Multimodality imaging of the painful elbow: Current imaging concepts and image-guided treatments for the injured thrower’s elbow // Radiologic Clinics of North America. 2016. Vol. 54, no. 5. P. 817–839.Stratchko L., Rosas H. Imaging of elbow injuries // Clinics in Sports Medicine. 2021. Vol. 40, no. 4. P. 601–623.Stratchko L., Rosas H. Imaging of elbow injuries // Clinics in Sports Medicine. 2021. Vol. 40, no. 4. P. 601–623.Beckmann N. M., Brown K. N. Imaging of elbow trauma // Atlas of emergency imaging from head-to-toe / Patlas M. N., Katz D. S., Scaglione M., eds. Cham : Springer, 2021. P. 591–609.Beckmann N. M., Brown K. N. Imaging of elbow trauma // Atlas of emergency imaging from head-to-toe / Patlas M. N., Katz D. S., Scaglione M., eds. Cham : Springer, 2021. P. 591–609.O’Driscoll S. W. Editorial commentary: It’s the fracture, not the fragment, that causes the pain: Posteromedial elbow impingement in baseball players // Arthroscopy. 2018. Vol. 34, no. 1. P. 111–113.O’Driscoll S. W. Editorial commentary: It’s the fracture, not the fragment, that causes the pain: Posteromedial elbow impingement in baseball players // Arthroscopy. 2018. Vol. 34, no. 1. P. 111–113.Matsuura T., Iwame T., Suzue N. et al. Clinical outcome of arthroscopic treatment for posteromedial elbow impingement in adolescent baseball players // Arthroscopy. 2018. Vol. 34, no. 1. P. 105–110.Matsuura T., Iwame T., Suzue N. et al. Clinical outcome of arthroscopic treatment for posteromedial elbow impingement in adolescent baseball players // Arthroscopy. 2018. Vol. 34, no. 1. P. 105–110.Liman M. N. P., Avva U., Ashurst J. V. et al. Elbow trauma // StatPearls. Treasure Island (FL) : StatPearls Publishing, 2023. URL: https://www.ncbi.nlm.nih.gov/books/NBK542228/ (дата обращения: 20.04.2024).Liman M. N. P., Avva U., Ashurst J. V. et al. Elbow trauma // StatPearls. Treasure Island (FL) : StatPearls Publishing, 2023. URL: https://www.ncbi.nlm.nih.gov/books/NBK542228/ (дата обращения: 20.04.2024).Dines J. S., Williams P. N., ElAttrache N. et al. Platelet-rich plasma can be used to successfully treat elbow ulnar collateral ligament insufficiency in high-level throwers // American Journal of Orthopedics (Belle Mead, N.J.). 2016. Vol. 45, no. 5. P. 296–300.Dines J. S., Williams P. N., ElAttrache N. et al. Platelet-rich plasma can be used to successfully treat elbow ulnar collateral ligament insufficiency in high-level throwers // American Journal of Orthopedics (Belle Mead, N.J.). 2016. Vol. 45, no. 5. P. 296–300.Andelman S., DiPrinzio E., Hausman M. Elbow injuries in the pediatric athlete // Annals of Joint. 2018. Vol. 3. P. 21.Andelman S., DiPrinzio E., Hausman M. Elbow injuries in the pediatric athlete // Annals of Joint. 2018. Vol. 3. P. 21.Chauvin N. A., Gustas-French C. N. Magnetic resonance imaging of elbow injuries in children // Pediatric Radiology. 2019. Vol. 49, no. 12. P. 1629–1642.Chauvin N. A., Gustas-French C. N. Magnetic resonance imaging of elbow injuries in children // Pediatric Radiology. 2019. Vol. 49, no. 12. P. 1629–1642.Nguyen J. C., Degnan A. J., Barrera C. A. et al. Osteochondritis dissecans of the elbow in children: MRI findings of instability // American Journal of Roentgenology. 2019. Vol. 213, no. 5. P. 1145–1151.Nguyen J. C., Degnan A. J., Barrera C. A. et al. Osteochondritis dissecans of the elbow in children: MRI findings of instability // American Journal of Roentgenology. 2019. Vol. 213, no. 5. P. 1145–1151.Richardson M., Kuester V. G., Hoover K. The usefulness of MRI in atypical pulled/nursemaid’s elbow: A case report // Journal of Pediatric Orthopaedics. 2012. Vol. 32, no. 5. P. e20–e22.Richardson M., Kuester V. G., Hoover K. The usefulness of MRI in atypical pulled/nursemaid’s elbow: A case report // Journal of Pediatric Orthopaedics. 2012. Vol. 32, no. 5. P. e20–e22.Sullivan C. W., Herron T., Hayat Z. Olecranon fracture // StatPearls. Treasure Island (FL) : StatPearls Publishing, 2023. URL: https://europepmc.org/article/NBK/nbk537295 (дата обращения: 20.04.2024).Sullivan C. W., Herron T., Hayat Z. Olecranon fracture // StatPearls. Treasure Island (FL) : StatPearls Publishing, 2023. URL: https://europepmc.org/article/NBK/nbk537295 (дата обращения: 20.04.2024).Alrabaa R. G., Dantzker N., Ahmad C. S. Injuries and conditions affecting the elbow flexor/pronator tendons // Clinics in Sports Medicine. 2020. Vol. 39, no. 3. P. 549–563.Alrabaa R. G., Dantzker N., Ahmad C. S. Injuries and conditions affecting the elbow flexor/pronator tendons // Clinics in Sports Medicine. 2020. Vol. 39, no. 3. P. 549–563.

The authors declare that there are no conflicts of interest present.