X线、CT扫描在后内侧改良L形切口治疗复杂后pilon骨折患者骨折复位中的价值  

The Values of X-ray and CT Scanning in the Treatment of Complicated Posterior Pilon Fracture with Modified L-shaped Posterior Medial Incision

作　　者：秘君 MI Jun(Department of radiology,Santan hospital,Tianjin 300193)

机构地区：[1]天津市南开区三潭医院放射科,天津300193

出　　处：《中国伤残医学》2023年第12期18-21,26,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：对比分析X线、CT扫描在后内侧改良L形切口治疗复杂后pilon骨折患者骨折复位情况中的价值。方法:选择我院2019年1月—2022年10月诊治的复杂后pilon骨折患者88例作为研究对象,所有患者都给予基于后内侧改良L形切口的内固定治疗,X线组给予X线平片进行辅助治疗,CT组给予多排螺旋CT进行辅助治疗,观察与记录2组的复位与预后效果。结果:CT组术后3个月的踝关节骨折复位优良率为97.7%,与X线组的84.09%相比,有显著提高(P<0.05);2组术后3个月的VAS评分明显低于术前1天(P<0.05),Olerud-Molander评分与术前1天对比也有显著增高(P<0.05),CT组术后3个月的VAS评分、Olerud-Molander评分与X线组对比也有显著差异(P<0.05);CT组术后3个月的腓肠神经刺激征、切口感染、跗管综合征等并发症发生率为2.3%,与X线组的15.9%对比,有显著降低(P<0.05);2组术后3个月的FAR1与FAR2都显著高于术前1天(P<0.05),CT组术后3个月的FAR1、FAR2与X线组对比也有明显提高(P<0.05)。结论:相对于X线,CT扫描在后内侧改良L形切口治疗复杂后pilon骨折患者的应用能促进骨折复位,减少并发症的发生,也可促进疼痛缓解,提高患者的FAR1与FAR2,从而持续改善患者的踝关节功能。Objective:To compare and analysis the values of X-ray and CT scanning in the treatment of complicated posterior pilon fracture with modified L-shaped posterior medial incision.Methods:88 patients with complicated posterior pilon fracture who were diagnosed and treated in a certain hospital from January 2019 to October 2022 were selected as the study subjects.All patients were treated with internal fixation based on the modified L-shaped posterior medial incision.The X-ray group were treated with X-ray plain film for auxiliary treatment,and the CT group were treated with multi-slice spiral CT for auxiliary treatment.The reduction and prognosis of the two groups were observed and recorded.Results:The excellent and good rate of ankle fracture reduction in CT group were 97.7%,which were significantly higher than 84.09%in X-ray group(P<0.05).The VAS score of the two groups at 3 months after operation were significantly lower than that of the first day before operation(P<0.05),and the Olerud-Molander score were also significantly higher than that of the first day before operation(P<0.05).The VAS score and Olerud-Molander score of the CT group at 3 months after operation were also significantly different from that of the control group(P<0.05).The incidence rates of complications such as sural nerve stimulation syndrome,incision infection and tarsal tunnel syndrome in the CT group were 2.3%,which were significantly lower than that in the X-ray group(15.9%,P<0.05).The FAR1 and FAR2 in the two groups were significantly higher at 3 months after operation than at 1 day before operation(P<0.05).The FAR1 and FAR2 in the CT group were also significantly higher than those in the X group at 3 months after operation(P<0.05).Conclusion:Compared with X ray,the application of CT scan in the treatment of complicated posterior pilon fracture patients with modified L-shaped incision in the posterior medial side can promote fracture reduction,reduce the occurrence of complications,and also promote pain relief,improve the FARl and FAR2 of

关 键 词：X线 CT扫描 后内侧改良L形切口 复杂后pilon骨折 骨折复位 踝关节功能 

分 类 号：R445[医药卫生—影像医学与核医学]