摘要
目的通过绘制股骨转子间骨折后内侧壁骨折地图,探讨股骨转子间骨折后内侧壁骨折线的分布特征和规律。方法回顾性分析2009年1月至2018年10月期间成都大学附属医院骨科收治的136例累及后内侧壁的股骨转子间骨折患者资料。男57例,女79例;平均年龄为64岁(48~81岁);骨折AO分型:31-A2型骨折101例,31-A3型骨折35例。收集其CT资料并予以三维重建,通过对股骨干及小转子特定标志物进行比对,将三维CT叠加并定向拟合于股骨转子间后内侧壁标准模型,绘制骨折地图。测量其后内侧壁骨折高度、宽度、面积及骨折线走行角度等,描述骨折线形态。结果136例股骨转子间骨折患者后内侧壁骨折高度为(48.76±4.11)mm、宽度为(29.78±3.29)mm、面积为(1468.47±75.26)mm^2,骨折线走形角度为49.93°±13.05°,骨折面积比(骨折区面积/后内侧壁面积比)为38.34%±16.58%。后内侧壁骨折地图的特点:骨折线在小转子区域及其前方分布密集。31-A2型骨折后内侧壁骨折线多集中于小转子及其下方,骨折线呈前上至后下方斜形破坏股骨距下段。31-A3型骨折线集中于小转子及其上方区域,呈前下至后上方斜形破坏股骨距上段。结论该骨折地图可以提高对股骨转子间骨折后内侧壁骨折的直观认识,并完善AO分型中31-A2型、31-A3型骨折对后内侧壁骨折线分布的描述。
Objective To investigate the distribution characteristics of the fracture lines on the posteromedial wall by mapping the femoral intertrochanteric fractures involving the posteromedial wall on 3D CT.Methods A retrospective study was conducted of the 136 patients with femoral intertrochanteric fracture who had been treated at Department of Orthopaedics,Affiliated Hospital to Chengdu University from January 2009 to October 2018.They were 57 men and 79 women with an average age of 64 years(from 48 to 81 years).By the AO classification,101 cases were type 31-A2 and 35 type 31-A3.Their CT data were collected for 3D reconstruction.By comparing the specific markers on the femoral shaft and lesser trochanter,the 3D CT reconstruction images were superimposed and orientated to the standard models of intertrochanteric posteromedial wall to create a map of the fracture.The width,height,area,and fracture deviation angle of the fracture of posteromedial wall were measured to characterize the distribution of the fracture lines.Results In the 136 femoral intertrochanteric fractures involving the posteromedial wall,the height of the posteromedial wall fracture was 48.76±4.11 mm,the width 29.78±3.29 mm,the area 1,468.47±75.26 mm2,and the fracture deviation angle 49.93°±13.05°.The fracture area ratio(fracture area/posteromedial wall area)was 38.34%±16.58%.On the map of the posteromedial wall fracture,the fracture lines were densely distributed in the lesser trochanter and in front of it.In the fractures of type 31-A2,the lines of the posteromedial wall fracture were mostly distributed in the lesser trochanter and below it,going obliquely from anterosuperior to posteroinferior to affect the lower calcar femorale.In the fractures of type 31-A3,the lines of the posteromedial wall fracture were mostly distributed in the lesser trochanter and above it,going obliquely from anteroinferior to posterosuperior to affect the upper calcar femorale.Conclusion The fracture map can help visual understanding of the intertrochanteric fracture involving the posteromedial wall,and provide further characterization of the posteromedial wall fracture in the fractures of AO types 31-A2 and 31-A3.
作者
王郑浩
李开南
兰海
Wang Zhenghao;Li Kainan;Lan Hai
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2019年第9期745-751,共7页
Chinese Journal of Orthopaedic Trauma
基金
国家科技支撑计划项目子课题(2016YFC0105806).
关键词
髋骨折
地图
成像
三维
股骨距
后内侧壁
Hip fractures
Map
Imaging,three dimensional
Femoral calcar
Posterior medial wall
