隐匿性足Lisfranc损伤的临床特征及多层CT表现  

The clinical characteristics and MDCT findings of the occult Lisfranc injuries

作　　者：张玉新[1] 王淑丽[1] 马信龙[1] 李健[1] 邓欣[1] 陈菲[1] 

机构地区：[1]天津医院,天津300211

出　　处：《中国临床医学影像杂志》2013年第3期188-191,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨隐匿性足轻微Lisfranc损伤的临床特征及多层CT的特征性影像改变。方法:从医院PACS系统中近1年内进行足CT检查的706例中统计出因足扭伤就诊而患者CR片显示阴性的轻微Lisfranc损伤图像,回顾性分析多层CT的多平面重组图像,分析其临床及影像学特征。结果:本研究中285例CR检查未见明显异常的患者,占全部足CT检查的41.4%,其中轻微隐匿Lisfranc损伤(不同部位的撕脱或裂纹骨折)82例,累及后足或单纯后足微细骨折41例,CR片对足跗骨及跖骨基底微细骨折的漏诊率达39.6%。轻微Lisfranc损伤以撕脱骨折为主,占70.9%,其次为裂纹骨折;跖底侧损伤占53.1%。临床特征包括疼痛(100%)和足肿胀(73.2%,60/82)。结论:足部隐匿性Lisfranc损伤在临床中非常常见,常规CR片很难准确诊断,多层CT对足部撕脱骨折及裂纹骨折等微细隐匿性损伤的诊断非常明确。Objective： To explore the clinical characteristics and MDCT findings of the subtle occult Lisfranc injury. Methods： During a period of 12 months in 2011, 706 patients had sprain injury of the foot underwent MDCT of the foot. Among them, occult Lisfranc injuries are not detected on conventional radiography. Imaging studies of MDCT were retrospectively re-evaluated for fracture location, and fracture types. Results： Of the 706 patients, 285 patients were normal on the radiological diagnosis. Among 285 patients, 113 （39.6%） had one or more subtle fractures in the tarsals and the base of the metatarsals. Subtle occult Lisfrane injury were found in 82 patients. Pain and midfoot swellitig were the main clinical characeristics. Common causes of indirect trauma include athletic injuries and falling from a high place. Conclusion： Subtle Lisfranc injuries are increasing and their correct diagnosis is important. Misdiagnosis is common and can lead to chronic disability. In patients with Lisfrane injuries, MDCT is recommended as the useful imaging technique.

关 键 词：足损伤 体层摄影术 螺旋计算机 

分 类 号：R684[医药卫生—骨科学] R814.42[医药卫生—外科学]