距骨完全脱位的影像诊断并文献回顾  

The imaging diagnosis of total dislocation of talus and review of literatures

作　　者：邱运东 宋彦芳 陈永忠 王达 王小天[4] 李锡 张平[3] 张泽坤 QIU Yundong;SONG Yanfang;CHEN Yongzhong;WANG Da;WANG Xiaotian;LI Xi;ZHANG Ping;ZHANG Zekun(Departmentof Radiology,Gu’an County Hospitalof Chinese Medicine,Gu’an,Hebei Province 065500,China;Departmentof Radiology,Hebei Province Hospital of Chinese Medicine,Shijiazhuang 050013,China;CT Room,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;Departmentof Orthopedics,Hebei Province Hospital of Chinese Medicine,Shijiazhuang 050013,China)

机构地区：[1]固安县中医院放射科,河北固安065500 [2]河北省中医院放射科,河北石家庄050013 [3]河北医科大学第三医院CT室,河北石家庄050051 [4]河北省中医院骨科,河北石家庄050013

出　　处：《实用放射学杂志》2022年第5期804-806,835,共4页Journal of Practical Radiology

基　　金：河北省财政厅政府资助卫生健康优秀人才专项经费项目(2020048134).

摘　　要：目的分析距骨完全脱位(TDT)的影像学征象及特点。方法回顾性分析6例TDT的图像,检索国内临床资料完整的TDT文献8篇24例病例,综合分析影像学特点及征象。结果6例TDT冠状面距骨外移5例、外翻2例、内翻1例;矢状面距骨前移5例、跖屈1例、背屈1例;横断面距骨外移5例、内收3例;综合文献30例TDT患者中,距骨向前外侧脱位11例,距骨向外脱位10例,距骨向内脱位4例,距骨向内前脱位2例,距骨向内后脱位1例,距骨180°翻转脱位、滑车面朝下1例,距骨缺失1例;伴发距骨撕脱骨折16例,内踝骨折12例,外踝骨折5例;术后感染4例,距骨缺血性坏死7例,创伤性关节炎9例。结论TDT为胫距关节、距下关节及距舟关节均失去正常对应关系为特点,以距骨前外侧、外侧旋转移位多见,常伴有周围骨质骨折。Objective To analyze the imaging signs and characteristics of total dislocation of talus(TDT).Methods A total of 6 cases with TDT were retrospectively analyzed and 8 domestic literatures including 24 cases with TDT were searched and collected.All the imaging features and signs were further comprehensively analyzed.Results Of the 6 cases in this study,5 cases were with externally moved talus,2 cases with valgus talus and 1 case with varus talus in coronal plane;5 cases with forward moved talus,1 case with plantar flexion and 1 case with dorsal flexion in sagittal plane;5 cases moved externally and 3 cases moved internally in axial plane.Of the 30 cases with TDT in the current study and reviewed papers,11 cases showed anterolateral dislocation,10 cases showed external dislocation,1 cases showed internal dislocation,2 cases showed anteromedial dislocation,1 case showed posteromedial dislocation,1 case showed 180°flotation dislocation with pulley face adown,l case showed talus disappeared;16 cases accompanied with talar avulsion fracture,12 cases with medial malleoluvS fracture and 5 cases with lateral malleoluvS fracture;4 cases occurred postoperative infection,7 cases showed talus suffered ischemic necrosis,and 9 cakses di.splayed traumatic arthritis.Conclusion TDT is characterized by the loss of normal correspondence of the tibiotalar joint,subtalar joint and talonavicularjoint.lt is usually with anterolateral and lateral rotational displacement of the talus,with fractures of the surrounding bone.

关 键 词：胫距关节 距下关节 脱位 骨折 计算机体层成像 

分 类 号：R681.8[医药卫生—骨科学] R683.42[医药卫生—外科学] R814.42[医药卫生—临床医学]