Analysis of the diagnostic and therapeutic value of high-frequency ultrasound,X-ray,and CT scanning in children with distal fibular epiphyseal avulsion fractures

LI Tie-song; HOU Ji-guang; HAO Jian

doi:10.3969/j.issn.2095-252X.2025.11.008

Abstract：Objective To explore the value of ultrasound,X-ray,and CT in the diagnosis and treatment of distal fibular epiphyseal avulsion fractures in children.Methods Collect clinical data of 77 children with distal fibular fractures who were treated in the hospital from June 2019 to June 2022.Within 48 hours of admission,high-frequency ultrasound,X-ray,and CT examinations were performed.Using CT examination results as the gold standard,the diagnostic and therapeutic value of ultrasound,X-ray,and CT examinations for distal fibular epiphyseal avulsion fractures were compared.Results CT examination confirmed that 69 cases were of distal fibular epiphyseal avulsion fractures,with a male majority of 63.77%.The main cause was sports injury,accounting for 40.58%.Ogden Ⅶ type fractures were more common,accounting for 39.13%.Reduction fixation and ankle joint fixation were more common,accounting for 46.38%.The sensitivity of X-ray and high-frequency ultrasound diagnosis was 71.01%and 94.20%,respectively(χ2=12.912,P=0.000);the specificity was 50.00%and 87.50%,respectively(χ2=2.618,P=0.106);and the diagnostic accuracy was 68.83%and 93.51%,respectively(χ2=15.336,P=0.000).The diagnostic accuracy of high-frequency ultrasound for Ogden Ⅶ type fracture was 96.30%,which was higher than the accuracy of X-ray examination by 77.78%.The differences between the two were statistically significant(χ2=4.103,P=0.043).There was no significant difference in the diagnostic accuracy of Salter Harris Ⅰ,Salter Harris Ⅱ,Salter Harris Ⅲ,Salter Harris Ⅳ,and Range Ⅵ fractures between the two examinations(P>0.05).The area under the curve of high-frequency ultrasound and X-ray signs in diagnosing distal fibular epiphyseal avulsion fracture was above 0.7,and the area under the curve of high-frequency ultrasound was greater than that of X-ray.Conclusions Compared with X-ray,high-frequency ultrasound has important application value in the diagnosis and treatment of distal fibular epiphyseal avulsion fracture in children.It is an indispensable auxiliary diagnostic and treatment method for distal fibular epiphyseal avulsion fractures in children by its high image resolution,high quality,economic simplicity,safety,non-radiation property,and good repeatability.