多层螺旋CT三维重建在评估老年肱骨骨折分型和疗效中作用  

The Role of MSCT Three-dimensional Reconstruction in Evaluating the Classification and Curative Effect of Elderly Humeral Fractures

作　　者：付琳琳[1] 肖世骞[1] 孙素晔 FU Lin-lin;XIAO Shi-qian;SUN Su-ye(Digital Subtraction Room,Tianjin Hospital,Tianjin,300000,China)

机构地区：[1]天津医院数字减影室,天津300000

出　　处：《黑龙江医学》2022年第13期1587-1589,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨多层螺旋CT(MSCT)三维重建在评估老年肱骨骨折分型和疗效中作用。方法:采用回顾性分析方法,选择2017年6月—2018年9月天津医院收治的62例老年肱骨骨折患者作为研究对象,按照术前检查方法不同分为A组(n=29)和B组(n=33)。A组术前行X线检查,B组术前行X线联合MSCT三维重建。采用AO分型法,根据骨折粉碎程度以及骨折线位置将肱骨骨折分为C1、C2和C3型,根据分型结果制定手术方案,观察62例患者术中所见骨折形态,比较两组患者术中所见骨折形态和术前评估吻合情况。随访2年,采用改良的Cassebaum肘关节评分系统评估两组患者肘关节功能。结果:经手术证实,62例患者均为肱骨近端骨折,其中C1型18例,C2型27例,C3型17例;B组患者术中所见骨折形态和术前评估完全吻合率比A组高,差异有统计学意义(χ^(2)=5.287,P<0.05);随访2年,B组术后肘关节优良率比A组高,差异有统计学意义(χ^(2)=4.415,P<0.05)。结论:对老年肱骨骨折患者采用MSCT三维重建,能够提高术前评估骨折分型吻合率,并可提高患者术后肘关节优良率。Objective:To explore the role of multi-slice spiral CT(MSCT)three-dimensional reconstruction in evaluating the classification and curative effect of elderly humeral fractures.Methods:A retrospective analysis method was used to select 62 el⁃derly patients with humeral fractures admitted to the hospital from June 2017 to September 2018 as the research subjects,and they were divided into group A(n=29)and group B(n=33)according to different preoperative examination methods.Group A underwent X-ray examination before operation,and group B underwent X-ray combined with MSCT three-dimensional reconstruction before operation.The AO classification method was used to classify humeral fractures into C1,C2,and C3 types according to the degree of fracture comminuted and the location of the fracture line.According to the classification results,the operation plan was formulated,and the fracture morphology of the 62 patients was observed during the operation.The intraoperative fracture morphology and preoperative assessment of anastomosis were compared between the two groups.After two years of follow-up,the modified Casse⁃baum elbow joint scoring system was used to evaluate the elbow joint function of the two groups.Results:All 62 patients were con⁃firmed by operation to have proximal humerus fractures,including 18 cases of type C1,27 cases of type C2,and 17 cases of type C3.The complete anastomosis rate of fracture morphology and preoperative assessment in group B was higher than that in group A,and the difference was statistically significant(χ^(2)=5.287,P<0.05).After two years of follow-up,the excellent and good rate of el⁃bow joint in group B was higher than that in group A,and the difference was statistically significant(χ^(2)=4.415,P<0.05).Conclu⁃sion:The use of MSCT three-dimensional reconstruction in elderly patients with humeral fracture can improve the preoperative evaluation of fracture classification and anastomosis rate,and can improve the postoperative excellent and good rate of the elbow joint.

关 键 词：多层螺旋CT三维重建 老年肱骨骨折 骨折分型 临床疗效 

分 类 号：R681.7[医药卫生—骨科学]