Post-traumatic Avascular Necrosis: Application of the Hawkins Sign in the Talus and the Femoral Head

外傷後缺血性骨壞死：“Hawkins徵像”在踝骨與股骨頭之應用

李英玄(Alex Ying-Shyuan Lee) ； 藍顥章(Howard Haw-Chang Lan) ； 李三剛(San-Kan Lee)

《中華放射線醫學雜誌》 24卷6期 (1999/12) Pp. 227-231

摘要

對於踝骨頸部骨折的病患而言，若X光素片出現『Hawkins徵像』則可確定踝骨體部將不會發生缺血性壞死。然而它並未被應用在股骨頸部骨折的病例上。我們評估『Hawkins徵像』應用在股骨頸部骨折病例的可行性且同時和踝骨骨折的病例做比較。回溯本院過去10個踝骨骨折以及12個股骨頸部骨折病患的一般X光素片後，我們做了初步的結論：『Hawkins徵像』可以有效預測骨折後踝骨體部的血流供應情形，但並不適用在股骨頸部骨折的病例上。

關鍵字

壞死 ； 股骨，骨折 ； 踝骨，骨折 ； 外傷 ； Hawkins徵像 ； 放射線攝影術

並列摘要

The Hawkins sign was thought to be useful as an early negative predictor of avascular necrosis (AVN) following a fracture through the talar neck. It had not, however, been applied to fractures through the femoral neck. We evaluated the applicability of the Hawkins sign for fractures through the femoral neck, and compared with those through the talus. Radiographs of 10 ankles with fracture of the talus and 12 hips with fracture of the femoral neck in our hospital were reviewed retrospectively. In 6 of the ankles, the Hawkins sign was positive without evidence of AVN on serial follow-up radiographs. The rest of the ankles in which the Hawkins sign was absent eventually developed AVN. In contrast, none of the hips showed a positive Hawkins sign, but AVN was noted in only 2 cases. We concluded that the Hawkins sign is useful for prediction of the blood-supply status of the talar body, but not for the femoral head. The cause of this discrepancy between the talus and the femur is unknown. Different areas of weight-bearing may be a possible factor. A further study with a large number of cases and with long-term longitudinal radiographic follow-up is necessary.

並列關鍵字

Necrosis ； Femur, fracture ； Talus, fracture ； Trauma ； Hawkins sign ； Radiography