胫骨平台合并急性软组织损伤的骨折相关放射学评估的不同预测标准  

Different predictive criteria for fracture-related radiological assessment of the tibial plateau in combination with acute soft tissue injury

作　　者：史晓远 彭亮[1] 曹万军[1] 陈星宇[1] 刘颖[1] 王晓刚 张清宴 SHI Xiaoyuan;PENG Liang;CAO Wanjun;CHEN Xingyu;LIU Ying;WANG Xiaogang;ZHANG Qingyan(Department of Orthopedics and Traumatology,Sichuan Orthopaedic Hospital,Chengdu Sichuan 610041,China)

机构地区：[1]四川省骨科医院创伤骨科,四川成都610041

出　　处：《中国急救复苏与灾害医学杂志》2023年第9期1215-1218,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：青年科学基金项目(编号:81901026)。

摘　　要：目的通过磁共振图像(MRI)评估胫骨平台骨折中软组织损伤的发生率,并揭示关节增宽/凹陷与半月板和韧带紊乱风险之间的关系。方法共有51名胫骨平台骨折的患者进行了手术干预。通过MRI评估了软组织损伤。对MRI上的半月板、前/后交叉韧带和内/外侧韧带损伤进行了评估。关节增宽/凹陷是通过图片存档和通信系统测量的。Schatzker的骨折类型分类与软组织损伤没有明显关系。结果Ⅳ型和Ⅱ型的软组织损伤率(分别为85.7%和74.1%)高于其他类型。半月板损伤是最常见的软组织损伤,半月板损伤的发生率为52.9%。当LPDCT和LPWCT分别约为7.6 mm和10.1 mm,LPDX-ray和LPWX-ray分别为5.6 mm和7.4 mm时,应更加关注Ⅰ、Ⅱ和Ⅲ型的副韧带和十字韧带损伤。此外,当LPWCT和LPWX-ray分别为10.3和8.6 mm时,Ⅳ型和Ⅴ型的副韧带和十字韧带容易受伤。结论胫骨平台骨折可发生高发病率的软组织损伤,包括半月板和韧带紊乱。X线和CT扫描对软组织损伤有不同的预测标准,胫骨平台的关节增宽/凹陷与半月板和韧带损伤有关。Objective To assess the incidence of soft tissue injury in tibial plateau fractures by magnetic resonance imaging(MRI)and to reveal the relationship between joint widening/depression and the risk of meniscal and ligamentous disorders.Methods A total of 51 patients with tibial plateau fractures,who were indicated for surgical intervention,underwent MRI to observe the injuries of soft tissues(meniscal,anterior/posterior cruciate ligament and medial/lateral ligaments)and antero-posterior filming and multiple detector comouted tomography(MDCT)to assess the joint widening/depression.Schatzker′ssystemwas used to of classify the tyre of fracture types.Results Soft tissue injury rates were higher for typesⅣandⅡ(85.7%and 74.1%,respectively)than for other types.Meniscal injuries were the most common soft tissue injury,with an incidence rate of 52.9%.When the values of lateral plateau depression(LPD)CT and LPW lateral plateau widening(LOW)CT were approximately 7.6 mm and 10.1 mm,respectively,and LPDXray and LPWX-ray were 5.6 and 7.4 mm,respectively,more attention should be paid to collateral and cruciate ligament injuries in typesⅠ,ⅡandⅢ.In addition,the collateral and cruciate ligaments of typesⅣandⅤwere susceptible to injury when the LPWCT and LPWX-ray values were 10.3 and 8.6 mm,respectively.Conclusion Tibial plateau fractures are often associated with soft tissue injury,including meniscal and ligamentous disorders.X-rays and CT scans have different predictive criteria for soft tissue injury,and joint widening/depression of the tibial plateau is associated with meniscal and ligamentous injury.

关 键 词：胫骨平台 急性软组织损伤 骨折 放射学评估 

分 类 号：R683[医药卫生—骨科学]