跗跖关节正斜位摄影技术临床初步应用研究  

The technique and application of anteroposterior and oblique radiographs of tarsometatarsal joints:a preliminary study

作　　者：桑辉[1] 陈永忠 刘业伟[1] 刘莹 张平[2] 贾丽英[1] 张泽坤 SANG Hui;CHEN Yongzhong;LIU Yewei;LIU Ying;ZHANG Ping;JIA Liying;ZHANG Zekun(Department of Radiology,Hebei Province Hospital of Chinese Medicine,Shijiazhuang 050011,China;CT Room,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北省中医院放射科,河北石家庄050011 [2]河北医科大学第三医院CT室,河北石家庄050051

出　　处：《实用放射学杂志》2020年第11期1849-1852,共4页Journal of Practical Radiology

摘　　要：目的比较跗跖关节正斜位摄影技术与常规足正斜位摄影技术对跗跖关节骨折脱位的诊断价值.方法跗跖关节损伤的患者26例,在拍摄常规足正斜位同时,加照跗跖关节正斜位,并对2组图像跗跖关节骨折脱位情况进行对比分析.结果26例跗跖关节损伤患者,左足7例,右足19例,常规足正斜位显示远排跗骨及跖骨基底骨折22处,跗跖关节正斜位显示远排跗骨及跖骨基底骨折40处,常规足正斜位相对于跗跖关节正斜位X线平片漏诊率为45%,跗跖关节正斜位与常规足正斜位X线平片诊断内侧楔骨、第2跖骨骨折时两者有统计学差异(χ^2=4.710、P=0.030,χ^2=6.240,P=0.012),2种检查技术均未发现中间楔骨、外侧楔骨及第5跖骨骨折.结论跗跖关节正斜位摄影技术在跗跖关节骨折的诊断中优于常规足正斜位,临床考虑跗跖关节损伤时可直接行跗跖关节正斜位摄影检查.Objective To explore the value of anteroposterior and oblique radiographs of tarsometatarsal(TMT)joints and conventional anteroposterior and oblique radiographs of the foot in the diagnosis of fracture-dislocations of the TMT joints.Methods A total of 26 patients with TMT joints injuries took both conventional anteroposterior and oblique radiographs of the foot and anteroposterior and oblique radiographs of TMT joints.The radiological demonstrations of the TMT joints in the two groups were compared and analyzed.Results Of all the 26 patients with TMT joints injuries,7 left feet and 19 right feet.A total of 22 distal tarsal fractures and metatarsal basal fractures were identified on the conventional anteroposterior and oblique radiographs of foot.A total of 40 distal tarsal fractures and metatarsal basal fractures were identified on the anteroposterior and oblique radiographs of TMT joints.Compared to anteroposterior and oblique radiographs of TMT joints,the misdiagnosis rate of conventional anteroposterior and oblique radiographs of the foot was 45%.There were significant difference between two kinds of radiographs in evaluating fractures of medial cuneiform bone and the second metatarsal bone,respectively(X^2=4.710,P=0,030,X^2=6.240,P=0.012).The fractures of intermediate cuneiform bone,lateral cuneiform bone,and the fifth metatarsal bone were not identified in the two radiographs.Conclusion Anteroposterior and oblique radiographs of TMT joints are better than conventional anteroposterior and oblique radiographs of the foot in diagnosing TMT fractures and dislocations.When TMT joint injury is considered clinically,anteroposterior and oblique radiographs of TMT joints can be performed directly.

关 键 词：跗跖关节 放射摄影术 骨折 脱位 

分 类 号：R816.8[医药卫生—放射医学] R814.41[医药卫生—临床医学]