跟骨骨折术后三维形态学特征与踝一后足功能的相关性：一项多中心研究结果  

A multi-center study on correlation between ankle.hindfoot function and three-dimeusional morpho- logical characteristic of ealcaneal fractures after surgical treatment

作　　者：陈雁西[1] 施忠民[2] 金丹[3] 徐海林[4] 洪劲松 强敏菲[1] 张坤[1] 郝旖旎[1] 梅国华[2] 薛剑锋[2] 胡稷杰[3] 

机构地区：[1]同济大学附属东方医院创伤骨科,上海200120 [2]上海市第六人民医院骨科 [3]南方医科大学南方医院创伤骨科 [4]北京大学人民医院创伤骨科 [5]广州市正骨医院骨科

出　　处：《中华骨科杂志》2013年第4期291-297,共7页Chinese Journal of Orthopaedics

摘　　要：目的探讨基于CT图像后处理技术的跟骨骨折术后三维形态学特征与踝一后足功能的相关性。方法2009年12月至2012年1月，按预设纳入标准、排除标准、退出标准，收集来自五所医院的146例跟骨骨折术后患者的临床治疗信息及CT薄层扫描的原始数据，采用容积重建法观察跟骨距下关节面的恢复状况；采用表面重建法结合三维组合式测量模式测量跟骨形态学相关参数；将观察及测量结果与患者的美国足踝外科协会（AmericanOrthopaedicFootandAnkleSociety，AOFAS）踝与后足功能评分结果进行相关性分析。结果男、女性组的跟骨长度、跟骨后关节面高度、跟骨后关节面长度均与AOFAS评分无相关性。男、女性组Gissane角与AOFAS评分呈负相关，Boehler角呈正相关。在距下关节面平整性观察中，关节面完全恢复平整有38例，其中AOFAS评分优良率为89．5％（34／38）；关节面不平整组有108例，优良率为90．7％（98／108）；两组间差异无统计学意义。结论跟骨骨折后的Gissane角、Boehler角对踝一后足功能恢复的影响较大；而跟骨长度、跟骨后关节面高度、跟骨后关节面长度及跟骨距下关节面的平整性与踝一后足功能恢复无相关性。Objective To find out the correlation of the ankle-hindfoot function to the three-dimen- sional morphological characteristic of ealcaneal fractures after surgical treatments based on the post-process- ing technique of CT images. Methods From December 2009 to January 2012, the original data of clinical information and CT scan of 146 patients with calcaneal fractures was collected in five hospitals according to the inclusion criteria, the exclusion criteria and the exit criteria. The original data was scanned by 16-detec- tor row CT scanner and the clinical information was collected from five hospitals. The restoration of the sub- talur facet was observed with the volume renderings. The surface shaded display （SSD） reconstruction com- bining three-dimensional measurement was utilized to measure the ealcaneus re]ated morphological parame- ters. The correlation study was carried out between the American Orthopaedic Foot and Ankle Society （AO- FAS） ankle-hindfoot score and the outcome after observation and measurement was analyzed. Results No significant correlation was found between the AOFAS score and the length of the calcaneus, the height of the posterior facet and the length of the posterior facet in male and female group. A significant inverse correla- tion was found between the Gissane angle and the AOFAS score in male group as well as in female group. A significant positive correlation was found between the B6h]er angle and the AOFAS score in male group as well as in female group. The congruity of the subtalar joint was observed in 38 cases, and the excellent and good rate of the AOFAS score was 89.5%. Unflat articular surface was found in 108 cases, and the excellent and good rate of the AOFAS score was 90.7%. Conclusion The restoration of ankle-hindfoot function was affected largely by part of angular parameters after calcaneal fractures, such as the Gissane angle and the Gissane angle; nevertheless part of morphological parameters and the congruity of the subtalar facet had no correlation to the res

关 键 词：跟骨 骨折 多中心研究 成像 三维 

分 类 号：R687.3[医药卫生—骨科学]