摘要
目的研究MSCT3D技术对于踝关节骨折Lauge-Hansen分型的诊断准确性及其适用范围。方法收集2017年1月-2017年12月间我院踝关节骨折患者300例,所有患者X线及CT诊断均按Lauge-Hansen分型,并将结果与术中所见进行对照,对Lauge-Hansen分型的准确性及适用性进行分析。将CT诊断分型与术中分型对照,判断CT3D技术的准确性。结果 MSCT3D技术对于踝关节骨折的分型准确性较X线高,二者差异有统计学意义(χ~2=14.063,P<0.01)。Lauge-Hansen分型的适用率约为96.37%,对Lauge-Hansen分型适用患者的临床手术证实其分型的准确率为96.89%。Lauge-Hansen分型缺陷:在直接或垂直暴力以及高能创伤引起的踝关节骨折中,Lauge-Hansen分型有其局限性。结论CT3D技术与Lauge-Hansen分型结合,对于踝关节骨折的诊断准确性较高,且CT3D技术对于骨折的形态表现和隐匿性骨折发现方面优势明显。结合Lauge-Hansen分型与CT3D技术对于踝关节损伤的治疗方案制定提供准确的参考。
Objective To study the diagnostic accuracy of MSCT3 D technique for type Lauge-Hansen fractures of ankle joint and its scope of application. Methods From January 2017 to December 2017 in our hospital 300 cases of ankle joint fracture patients, CT diagnosis of all patients were divided by Lauge-Hansen, and the results were compared with the intraoperative findings, the accuracy and applicability of Lauge-Hansen type carries on the analysis. The CT diagnostic typing typing and operation control, to determine the accuracy of CT3 S technique. Results MSCT3 D technology for high accuracy classification of ankle fractures, there was significant difference between the two groups(χ~2=14.063, P<0.01). Lauge-Hansen type rate is about 96.37%, the accuracy of clinical surgery Lauge-Hansen typing for patients with confirmed the type for 96.89%.Lauge-Hansen type defects: in direct violence, vertical violence and high trauma caused by ankle fracture Lauge-Hansen Type has its limitations. Conclusion CT3 D and LaugeHansen type with high diagnostic accuracy for ankle fracture, and CT3 D technology for the form and occult fracture found obvious advantages. Combining Lauge-Hansen and CT3 D technology for the treatment of ankle joint injury to provide accurate reference.
引文
[1]Jason P.Tartaglione MD,Andrew J.Rosenbaum MD,Mostafa Abousayed MD,et al.Classifications in Brief:Lauge-Hansen Classification of Ankle Fractures[J].Clin Orthop Relat Res,2015,473(10):3323-3328.
[2]Warner SJ,Garner MR,Hinds RM,et al.Correlation Between the LaugeHansen Classification and Ligament Injuries in Ankle Fractures[J].J Orthop Trauma,2015,29(12):574-578.
[3]Lauge-Hansen N.Fractures of the ankle.II.Combined experimentalsurgical and experimental-roentgenologic investigations[J].Arch Surg,1950,60(5):957-985.
[4]Jason P.Tartaglione MD,Andrew J.Rosenbaum MD,Mostafa Abousayed MD,et al.Classifications in Brief:Lauge-Hansen Classification of Ankle Fractures[J].Clin Orthop Relat Res,2015,473:3323-3328.
[5]尹萌辰,夏烨,严寅杰,等.踝关节损伤AO分型与Lauge-Hansen分型可信度和可重复性研究[J].中国中医骨伤科杂志,2014,22(6):8-12.
[6]曾效力,董相宇,肖秀云,等.踝关节外侧副韧带损伤M R I诊断与疗效观察[J].中国C T和M R I杂志,2017,15(1):137-140.
[7]Henari S,Banks LN,Radovanovic I,et al.Ultrasonography as a diagnostic tool in assessing deltoid ligament injury in supination external rotation fractures of the ankle[J].Orthopedics,2011,3(10):e639-e643.
[8]侯开宇,陆晓涛,王宇飞,等.急性踝关节骨折2 8 8例关节镜检查结果分析[J].中国骨与关节损伤杂志,2008,23(8):681-683.