超声判断股骨干中段骨折闭合复位髓内钉固定术后股骨的旋转畸形  

Ultrasound evaluation of femoral rotational deformity followina closed reduction and intramedullarynailing for fracture of middle femoral shaft

作　　者：付世杰[1] 张文云[1] 吴希瑞[1] 焦振清[1] 郑占乐[1] 张国川[1] 

机构地区：[1]河北医科大学第三医院创伤急救中心河北省骨科生物力学重点实验室,石家庄050051

出　　处：《中华创伤骨科杂志》2014年第2期98-103,共6页Chinese Journal of Orthopaedic Trauma

摘　　要：目的应用超卢判断股骨干中段骨折闭合复位髓内钉同定术后股骨的旋转状态并测量股骨的旋转畸彤角度，探讨本测镀力方法的精确。陀。方法本研究对象为2012年l月至2013年1月采用川合复位髓内钉旧定的20例成年股骨干中段骨折患者，男12例，女8例；年龄为18～52岁，甲均30．5岁。所有患者均为单侧例合性骨折。骨折按照AO／ASlF分别：32A2型8例，32Bl刑4例，3282型3例，32C2型5例。超声检查时间为髓内钉固定术后5-7d（半均5．7d）。术后患符取俯卧值，应用超声观测股骨粗线：分别托骨折远、近端观测股骨短轴，股骨粗线在尼示器上表现为尖状慢叫卢影；利川此影像特点，凋整超声探头角度，许应用直径为60cm的弧形苗角器测品股骨的旋转畸形角度。然后通过C1、测遗股骨旋转畸形角度米验证超声测量方法的精确性。结果20例患荇术后患肢应用超声测量的股骨旋转畸形角度平均为5．82°±3．38°，应用CT测镀的股骨旋转畸形角度平均为6．00°±3．72°，差值平均为-0．19°±1．02°，二者比较差异无统计学意义（t=0．808，P=0．429），超声测苗结果显示：骨折远端外旋畸形14例，内旋畸形5例，无旋转畸形1例。超声测疑与cT测量的结果、旋转方向完伞一致。结论超声观测患肢股骨粗线能准确地判断股骨干中段骨折闭合复位髓内钉固定术后股骨的旋转状态，并精确地测量出股骨的旋转畸形角度。Objective Tu assess the feasibility and accuracy of the uhrasound evaluation of femoral rotational dcformily folluwing closed reduction and intramedullary nailing for fracture of middle femoral shaft. Methods Enrolled in this study were 20 adult patients with fracture of middle femoral shaft who had been treated with closed redaction and intramedullary nailing from January 2012 tu January 2013 in our department. They were 12 men and 8 women, aged from 18 to 52 years （average, 30.5 years） . All the cases were uni- laieral closed fraetures. Ac（＇ording to the AO/ASIF classification, 8 cases were 32A2, 4 cases 32B1, 3 cases 32B2, and 5 cases 32C2. Ultrasound examinations were conducted 5 to 7 days postoperation （average, 5.7 clays）. The femoral thick line was observed with the patients in prone position. Next, the minor axis of femoral shaft was observed at both the proximal and distal ends of tire fracture. Based on the tip-shaped strong echo images of the ｜＇emoral thiek line on the screen, the angle of ultrasound probe was adjusted tn measure the ro- tational angle of the femoral deformity using an arc angle gauge, 60 cm in diameter. The accuracy of ultra- sound evaluation was verified by comparing the angles measured by ultrasound examination and by CT scan- ning. Results The ultrasonic measurement revealed that tbe average angle of the femoral rotational de- formity after nperalion was 5.82°±3.38° in the 20 patients. The CT measurement showed thai the average angle of the femoral rotational deformity was 6. 00° ± 3.72°. There was no statistically significant difference between the 2 measurements （ t = 0. 808, P = 0. 429） . According to the ultrasonic measurement, 14 cases had deformity of dislal external rotation, 5 deformity of inlernal rotation, and one was free of rotational de- formity, showing a complete agreement with the results of CT measurement. Conclusion Ultrasound e- valuation of the femoral thick line at the affected side can accurately detect the rotational condition of th

关 键 词：股骨骨折 骨折固定术 髓内 超声检查 旋转 

分 类 号：R687.3[医药卫生—骨科学]