X线、CT和3D-CT对外伤性髋关节脱位的诊断价值  

The Diagnostic Value of X Ray,CT and three D-CT about Traumatic Dislocation of Hip Joint

作　　者：赵益峰[1] 王仁成[2] 朱凤华 赵平厚[2] 李恒艳 张迪 朱宝林[2] 郭其勇[2] 于连祥[2] 

机构地区：[1]山东省泰山医学院,泰安市271000 [2]泰山医学院附属医院骨科 [3]莱钢集团公司总医院

出　　处：《骨与关节损伤杂志》2004年第11期745-748,共4页The Journal of Bone and Joint Injury

摘　　要：目的　分析外伤性髋关节脱位诊治中存在的问题并提出相应的对策。方法　回顾性分析 37例外伤性髋关节脱位的临床资料 ,并予以统计学处理。结果　 10例合并的髋部骨折、13例关节内碎骨片被X线片漏诊 ;中心型髋关节脱位及水平位髋臼骨折各 1例被常规CT遗漏 ;髋臼裂缝骨折及髋关节内碎骨片各 2例被三维CT漏诊 ;三维CT误诊关节内碎骨片 2例 ;且采用不同的影像学诊断方法 ,治疗效果明显不同。结论　不管任何类型的外伤性髋关节脱位在行X线片检查得到初步诊断后均应即刻手法复位 ,之后在行X线片复查的基础上 ,必须进行二维CT(有条件者包括三维CT)检查 ,以确定髋关节脱位、髋部骨折复位程度或确定是否并发骨折及分型 。Objective To analyze the problems existing in diagnosis and treatment about traumatic dislocation in hip joint and give out the corresponding counter plan.Methods The clinical data of 37 cases of traumatic dislocation in hip joint was reviewed and analyzed with means of statistics.Results The incidental sciatic fracture of 10 cases and the fragments of bone in joint of 13 cases were missed diagnosed by X-rays, one case of centric dislocation in hip joint and one case of horizontal fracture in acetabulum were missed diagnosed by routine CT, two cases of interstitial fracture in acetabulum and two cases of fragments of bone in hip joint were missed diagnosed by 3D-CT, and two cases were misdiagnosed that there were fragments of bone in joint by 3D-CT, besides the result was very different with different diagnostic methods in fluoroscopy.Conclusion Every type of traumatic dislocation in hip joint should be taken into the state of manual reposition at once after getting the elementary diagnosis with X-rays, then routine CT (3D-CT should be included if the condition allows) must be taken based on the countercheck with X-rays in order to confirm the degree of diaplasis in dislocation of hip joint and sciatic fracture or confirm if the sciatic fracture exists or not and what the type is, so that we can get the further therapeutic project.

关 键 词：X线 CT 3D-CT 外伤性髋关节脱位 诊断 

分 类 号：R684.7[医药卫生—骨科学]