DOI: 10.66106/jizhav.20250201 ISSN: 3105-6911

肋骨骨折合并肩锁关节脱位的漏诊分析（Analysis of Missed Diagnosis in Rib Fractures Combined with Acromioclavicular Joint Dislocation）

李家威 Jiawei Li, 闫雪松 Xuesong Yan, 范志鹏 Zhipeng Fan, 吴卓航 Zhuohang Wu, 张贵春 Guichun Zhang
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Abstract：Objective To explore how to effectively diagnose rib fractures combined with acromioclavicular joint dislocation, thereby reducing the missed diagnosis rate. Methods A retrospective case-control study was conducted to analyze 163 patients with rib fractures combined with acromioclavicular joint dislocation who met the inclusion criteria and were admitted to the 960th Hospital of the PLA Joint Logistics Support Force from June 1, 2014 to April 26, 2024. Among them, 73 patients underwent chest posteroanteri or X-ray examination, 48 patients underwent chest CT examination, and 42 patients underwent bilateral shoulder standing stress X-ray examination. The missed diagnosis situations of the three groups were statistically analyzed using chi-square test. Results There were significant differences in the missed diagnosis rates among the three groups (P=0.001). Further pairwise comparisons showed that there were statistically significant differences in missed diagnosis rates between chest posteroanterior X-ray and chest CT groups (P＜0.05), between chest posteroanterior X-ray and bilateral shoulder standing stress X-ray groups (P=0.001), and between chest CT and bilateral shoulder standing stress X-ray groups (P<0.05). Conclusion For patients with rib fractures, the acromioclavicular joint is prone to combined injuries, and there is a certain rate of missed diagnosis clinically. Careful inquiry of medical history, detailed physical examination, bilateral shoulder standing stress X-ray, bilateral shoulder CT scan with three-dimensional reconstruction, and MRI imaging technology can reduce the missed diagnosis rate of acromioclavicular joint dislocation.

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