摘要
[目的]利用CT及X线影像学技术对胫骨中下1/3螺旋形骨折合并后踝骨折进行研究,用于指导临床治疗。[方法]2010年3月-2012年8月胫骨中下1/3螺旋形骨折合并后踝骨折患者90例,年龄19-67岁、平均43.2岁,男56例、女34例,患者均行胫腓骨正侧位X线片及胫腓骨CT检查,依据横断面后踝骨折占胫骨远端关节面不同面积大小（SA≤25%、25%〈SB≤33%、33%〈SC≤50%）分为A、B、C 3组,同时测量横断面上后踝骨折块的最长长度LCD及矢状面上后踝骨折块的最大纵向长度LEF,测量X线侧位片上后踝骨折块的纵向长度Lef。对后踝骨折横断面面积S1和骨折块断层截面的最大面积S3大小进行研究。比较X线侧位片Lef和CT矢状面LEF上后踝骨折块的纵向长度。[结果]随着后踝骨折块远端关节面面积（SA、SB、SC）比例增大,其横断面上的最长长度LCD增加,差异有统计学意义（P〈0.05）。其矢状面上的最大纵向长度LEF也随之增加,差异有统计学意义（P〈0.05）。进而使得后踝骨折块断层截面的最大面积S3也在不断增加,差异有统计学意义（P〈0.05）。X线侧位Lef和CT矢状面LEF在后踝骨折块的纵向长度中的测量比较,CT矢状面上显示骨折线更加清楚,P〈0.05差异有统计学意义。[结论]通过CT检查不仅能敏感地诊断后踝骨折,而且结合胫骨远端横断面和矢状面,能更加准确的评估后踝骨折块大小,对于后踝骨折的固定具有重要意义。
[Objective]With use of CT and X- ray,the morphology of posterior malleolar fracture combined with spiral fracture of distal 1 /3 of tibia was studied,and this provides the basis for clinical treatment. [Method]From Mar 2010 to Aug2012,90 patients with spiral fracture of distal 1 /3 of tibia combined with posterior malleolar fracture were enrolled in this study,including 56 males and 34 females aged from 19 to 67 years（ mean 43. 2 years）. Lateral X ray and CT films of tibia and fibula of all patients were obtained. All patients were divided into 3 groups according to the surface area of posterior malleolar fracture on distal tibial articular surface on cross- sectional plane,i,e,group A with SA≤25%,group B with 25% SB≤33%,group C with 33% SC≤50%. The longest length of posterior malleolar fracture on cross- sectional plane（ LCD） and that on sagittal plane（ LEF） were measured,and the length of posterior malleolar fracture on lateral X ray film（ Lef） was also measured. The surface area of posterior malleolar fracture on cross- sectional plane（ S1） and the surface area of fault section（ S3） were studied. The Lefon lateral X ray film and LEFon CT sagittal plane were compared. [Result]According to increasing surface area of posterior malleolar fracture on distal tibial articular surface on cross- sectional plane,LCDincreased（ P〈0. 05）,and LEFalso increased（ P〈0. 05）. This also lead to increasing S3（ P〈0. 05）. Lefcompared with LEF for the measurement of longitudinal length of the fracture,the fracture line was more clearly displayed on CT sagittal plane（ P〈0. 05）. [Conclusion]CT examination is sensitive to posterior malleolar fractures,and the combination of CT cross sectional and sagittal plane of distal of tibia can more accurately assess the fracture size. This is of significant importance for fixation of posterior malleolar fracture.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2014年第22期2040-2043,共4页
Orthopedic Journal of China
基金
上海市卫生和计划生育委员会科研课题(编号:2013-319)
上海市金山区科技创新项目(编号:2012-3-08)
关键词
胫骨
后踝骨折
影像学
tibia
posterior malleolar fractures
imaging study
