CT观察下胫腓联合分离闭合复位与踝关节功能的相关性  

Correlation between closed reduction of distal tibiofibular syndesmosis separation and ankle joint function by CT observation

作　　者：申军国 王亚 刘娜 宋晓杰 SHEN Jun-guo;WANG Ya;LIU Na;SONG Xiao-jie(Department of Traumatic Orthopedics,North China Medical Health Group Xingtai General Hospital,Xingtai 054000,Hebei,China;De-partment of Blood Transfusion,North China Medical Health Group Xingtai General Hospital,Xingtai 054000,Hebei,China)

机构地区：[1]华北医疗健康集团邢台总医院创伤骨科,河北邢台054000 [2]华北医疗健康集团邢台总医院输血科,河北邢台054000

出　　处：《生物医学工程与临床》2024年第4期521-526,共6页Biomedical Engineering and Clinical Medicine

基　　金：邢台市重点研发计划项目(2022ZC087)。

摘　　要：目的研究CT下胫腓联合分离闭合复位与踝关节功能的相关性。方法选择2020年10月至2022年10月于华北医疗健康集团邢台总医院收治的单纯性下胫腓联合分离患者77例,其中男性43例,女性34例;年龄35~72岁,平均年龄52.54岁;骨折病程1~5 d,平均骨折病程2.87 d;跌落摔倒17例,重物砸伤16例,道路交通44例。患者均接受闭合复位治疗(保守治疗),并行CT检查。治疗前、治疗6个月后获取下胫腓联合CT相关参数(胫腓骨中心距离、胫腓骨间隙宽度、胫腓骨前缘距离),以及Baird-Jackson踝关节功能评分。比较不同类型患者各指标差异,并采用Pearson法分析下胫腓联合CT相关参数与Baird-Jackson踝关节功能评分的相关性。结果77例患者中,旋前外旋型45例,外展型20例,旋后外旋型12例。复位治疗后12个月,3组患者胫腓骨中心距离、胫腓骨间隙宽度、胫腓骨前缘距离差异无统计学意义(P>0.05)。3组患者踝关节功能评分平均分均高于93分,优良率均高于90%,差异无统计学意义(P>0.05)。闭合复位12个月后,胫腓骨中心距离、胫腓骨间隙宽度、胫腓骨前缘距离分别与Baird-Jackson评分呈负相关性(r=-0.649、-0.745、-0.716,P<0.001)。结论CT检查可清晰显示不同类型下胫腓联合分离的解剖特点,CT测量下胫腓联合解剖结构数值与踝关节功能存在相关性,可指导临床闭合复位治疗及预后评估。Objective To study the correlation between closed reduction of distal tibiofibular syndesmosis separation and ankle joint function by CT examination. Methods From October 2020 to October 2022, a total of 77 patients with simple tibiofibular syndesmosis separation were enrolled, which included 43 males and 34 females, aged 35-72 years old with mean age of 52.54 years old;fracture duration was 1-5 days with mean of 2.87 days. There were 17 cases of falling, 16 of heavy object injury, and 44 of road traffic. All of them performed closed reduction(conservative treatment) and CT examina tion. Before and 6 months after treatment, CT related parameters of distal tibiofibular syndesmosis(tibiofibular center distance, tibiofibular gap width, tibiofibular anterior border distance) and Baird-Jackson ankle function score were obtained.The differences of each index in different types of patients were compared, and the correlation between CT-related parameters of distal tibiofibular syndesmosis and Baird-Jackson ankle function score was analyzed by Pearson method. Results There were 45 cases of pronation-external rotation type, 20 of abduction type and 12 of supination-external rotation type in 77patients. Twelve-month after reduction treatment, there was no significant difference in tibiofibular center distance, tibiofibular gap width, tibiofibular anterior border distance in 3 groups(P > 0.05). The mean of ankle joint function scores in 3 groups were higher than 93 scores, and the superior rate were higher than 90 %, with no statistically significant difference( P > 0. 05).Twelve-month after closed reduction, the tibiofibular center distance, tibiofibular gap width, tibiofibular anterior border distance were negatively correlated with Baird-Jackson score( r =-0. 649,-0. 745,-0. 716, P < 0. 001). Conclusion It is demonstrated that CT examination could clearly display the anatomical characteristics of different types of distal tibiofibular syndesmosis separation, and anatomical structure of tibiofibular syndesmosis measured by

关 键 词：CT 下胫腓联合分离 闭合复位 踝关节功能 相关分析 

分 类 号：R687.3[医药卫生—骨科学]