术前X线、CT三维及二维影像重建对桡骨远端不稳定性骨折的评估意义  

Study on the significance of pre-operation assessment between X-ray and CT reconstruction measurement in unstable distal radial fractures

作　　者：赵亮[1] 王宝军[1] 高化[1] 白晓冬[1] 李亚东[1] 刘振宇[1] 陈文韬[1] 

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《临床和实验医学杂志》2017年第8期823-825,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的对比研究桡骨远端不稳定性骨折术前X线、CT三维及二维影像重建骨折的评估的异同及其对诊断、治疗意义。方法收集骨科自2013年5月至2016年2月桡骨远端不稳定性粉碎骨折病例资料29例,整理患者术前一般情况资料,术前数字X线正、侧位片,术前螺旋CT扫描并矢状位、冠状位二维及三维重建图像。根据X线、CT重建检查结果,分别确定桡骨远端不稳定性骨折的AO分型、关节面内骨折块数目、是否有关节面背侧骨折及骨折块的厚度、分离移位距离等指标。结果 X线AO分型A型10例,B型2例,C型c1为5例,c2为5例,c3为7例;CT分型A型1例,B型1例,C型c1为1例,c2为3例,c3为23例。RxC卡方检验McNemar-Bowker法,卡方值=20.0,P=0.001,有显著性统计学差异。X线检查及CT三维重建,对比术前桡骨远端关节内粉碎骨折块的数目(t=-13.09,P=0.001)、骨折块的分离移位距离(t=-2.326,P=0.031),经配对比较t检验,均有统计学显著性差异。结论术前数字X线及CT三维、二维重建评估关节内骨折,各有特点。CT重建,对于明确关节内骨折信息更精准,可靠,更具有指导意义。Objective To comparatively study the significance of assessment of pre - operation X - ray measurement and CT reconstruc-tion in patients with unstable distal radial fractures and their significance in diagnosis and treatment. Methods The clinical data of 29 patients with unstable distal radial fractures in this hospital during May, 2013 to February, 2016 were retrospectively compared and analyzed. Their general informations, anteroposterior and lateral X - ray films, 3D and 2D reconstruction CT imaging were classified by AO system, the measurement of number of fracture fragments in surface, the displacement and thickness of distal dorsal rim were analyzed with SPSS16.0. Results According to AO classification by X - ray films, 10 cases belonged to type A, 2 cases as type B, 5 cases as type Cl, 5 cases as type C2 and 7 cases as type C3. According to AO classification by CT reconstruction imaging, type A was in 1 case, type B in 1 case, type Cl in 1 case, type C2 in 3 cases and type C3 in 23 cases. The value of RxC chi - square test （ McNemar - Bowker） was 20. 0 , P =0. 001, there was statistically significant difference among them. There was statistical significant difference in number of fracture fragments in surface （ t = - 13.09,P = 0.001）, the displacement of distal dorsal rim （ t = -2.326, P = 0.031） and paired - t test between X - ray and CT reconstruction imaging. Conclusion The preopera-tion measurement of reconstruction of fractures in joint with X - ray examination and CT reconstruction imaging is useful, but CT reconstruction im-aging is more accurate, meticulous and suitable.

关 键 词：桡骨远端骨折 X线测量 CT重建 

分 类 号：R687.3[医药卫生—骨科学]