2196例成人踝关节骨折X线分析
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摘要
目的:分析成人踝关节骨折的临床流行病学规律,包括骨折类型及分布,探讨与受伤机制的关系。并统计易漏诊骨折及漏诊率。方法:将2013年1月-2015年12月3年间在河北医科大学第三医院就诊的成人新发踝关节骨折病例纳入统计范畴;用Danis-Weber分型和Lauge-Hansen分型进行骨折分型、分期统计。结果:踝关节骨折共2196例,其中以Weber A型占30%,Weber B型占42%,Weber C型占20%,垂直压缩骨折占8%;16~50岁年龄段男性及50岁以上年龄段女性构成两个骨折高峰人群,分别占踝关节骨折发生比率的39%和22%。后踝、高位腓骨、胫骨前外下缘处骨折容易发生漏诊,漏诊共24例。漏诊率为1.1%。结论:青壮年男性及老年女性为两个踝关节骨折高发群体。Danis-Weber分型结合Lauge-Hansen分型可帮助医师分析骨折致伤机制,预测骨折可能涉及范围,从而减少骨折漏诊,提高诊断准确性。
Objective: Analysis of clinical epidemiology characteristics of ankle fractures in adults, including fracture types and its distribution. To explore the relationship between these fractures and its mechanism of injury, and analysis of misdiagnosis of fracture and missed diagnosis. Methods: From January 2013 to December 2015 newly diagnosed adult patients with ankle fractures in the Third Hospital of Hebei Medical University were included in our research. The Danis-Weber Classification and Lauge-Hansen Classification were used to classify these fractures. Results: A total of 2 196 cases of ankle fractures,among them Weber type A accounted for 30%, Weber type B accounted for 42%, Weber type C accounted for 20%, vertical compression fractures accounted for 8%, 16~50 years old men accounted for 39%, women over 50 years of age accounted for22%. There were 13 cases of missed diagnosis. The posterior malleolus, upper fibula and the lower front part of the tibia are prone to missed the fracture diagnosis. The missed diagnosis rate was 1.1%. Conclusion: Young men and older women have a relatively high preference for ankle fractures. Danis-Weber classification combined with Lauge-Hansen classification can help doctors to analyze the mechanism of injury and may predict the range of fractures involved. Thereby reduce the missed diagnosis of factures and improve the diagnostic accuracy.
Objective: Analysis of clinical epidemiology characteristics of ankle fractures in adults, including fracture types and its distribution. To explore the relationship between these fractures and its mechanism of injury, and analysis of misdiagnosis of fracture and missed diagnosis. Methods: From January 2013 to December 2015 newly diagnosed adult patients with ankle fractures in the Third Hospital of Hebei Medical University were included in our research. The Danis-Weber Classification and Lauge-Hansen Classification were used to classify these fractures. Results: A total of 2 196 cases of ankle fractures,among them Weber type A accounted for 30%, Weber type B accounted for 42%, Weber type C accounted for 20%, vertical compression fractures accounted for 8%, 16~50 years old men accounted for 39%, women over 50 years of age accounted for22%. There were 13 cases of missed diagnosis. The posterior malleolus, upper fibula and the lower front part of the tibia are prone to missed the fracture diagnosis. The missed diagnosis rate was 1.1%. Conclusion: Young men and older women have a relatively high preference for ankle fractures. Danis-Weber classification combined with Lauge-Hansen classification can help doctors to analyze the mechanism of injury and may predict the range of fractures involved. Thereby reduce the missed diagnosis of factures and improve the diagnostic accuracy.
引文
[1]张英泽.临床创伤骨科流行病学[M].北京:人民卫生出版社,2009:140-142.
[2]陈雁西.踝关节骨折分型及特殊类型骨折治疗方法[J].中华创伤杂志,2015,31(2):104-106.
[3]赵海涛,陈伟,孙涛,等.2003年至2012年河北医科大学第三医院成人距骨合并同侧踝关节骨折的流行病学分析[J].中华创伤骨科杂志,2014,16(12):1089-1093.
[4]徐慧洪.多层螺旋CT三维重建技术在踝关节骨折诊断中临床价值[J].医学影像学杂志,2011,21(10):1613-1615.
[5]高化,赵亮,李亚东,等.踝关节骨折伴下胫腓联合分离的影像学分析[J].中华创伤骨科杂志,2013,15(12):1041-1044.
[6]马信龙.踝关节骨折的损伤机制[J].中华骨科杂志,2013,33(4):429-432.
[2]陈雁西.踝关节骨折分型及特殊类型骨折治疗方法[J].中华创伤杂志,2015,31(2):104-106.
[3]赵海涛,陈伟,孙涛,等.2003年至2012年河北医科大学第三医院成人距骨合并同侧踝关节骨折的流行病学分析[J].中华创伤骨科杂志,2014,16(12):1089-1093.
[4]徐慧洪.多层螺旋CT三维重建技术在踝关节骨折诊断中临床价值[J].医学影像学杂志,2011,21(10):1613-1615.
[5]高化,赵亮,李亚东,等.踝关节骨折伴下胫腓联合分离的影像学分析[J].中华创伤骨科杂志,2013,15(12):1041-1044.
[6]马信龙.踝关节骨折的损伤机制[J].中华骨科杂志,2013,33(4):429-432.