股骨内侧髁软骨下不全骨折与内侧半月板损伤模式及外突的相关性  

Correlations of medial femoral condyle subchondral insufficiency fracture with medial meniscus injury pattern and extrusion

作　　者：覃滢 李智晞 韦宝琛[4] 石桢松 刘晓岚[1] 韩秋丽[1,2,3] QIN Ying;LI Zhixi;WEI Baochen;SHI Zhensong;LIU Xiaolan;HAN Qiuli(Department of Radiology,Liuzhou People's Hospital Affiliated to Guangxi Medical University,Liuzhou 545006,China;Guangxi Key Clinical Specialties of Medical Imaging,Liuzhou People's Hospital Affiliated to Guangxi Medical University,Liuzhou 545006,China;Liuzhou Key Laboratory of Molecular Imaging,Liuzhou People's Hospital Affiliated to Guangxi Medical University,Liuzhou 545006,China;Department of Orthopaedic Surgery,Liuzhou People's Hospital Affiliated to Guangxi Medical University,Liuzhou 545006,China)

机构地区：[1]广西医科大学附属柳州市人民医院放射科,广西柳州545006 [2]广西医科大学附属柳州市人民医院广西医学影像临床重点专科,广西柳州545006 [3]广西医科大学附属柳州市人民医院柳州市分子影像重点实验室,广西柳州545006 [4]广西医科大学附属柳州市人民医院骨关节科,广西柳州545006

出　　处：《中国医学影像技术》2024年第9期1405-1409,共5页Chinese Journal of Medical Imaging Technology

基　　金：柳州市人民医院院内科研基金(lry202115);广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200159);柳州市个十百人才工程专项基金。

摘　　要：目的观察股骨内侧髁软骨下不全骨折(SIF)与内侧半月板损伤模式及内侧半月板外突(MME)的相关性。方法回顾性分析经临床确诊的36例单侧股骨内侧髁SIF患者,根据SIF分级分为低级别组与高级别组。对比组间软骨损伤分级、半月板损伤及MME,分析SIF分级与软骨损伤、骨坏死体积(OV)及MME的相关性;比较不同半月板外突分级患者软骨损伤分级、OV及MME,分析其相关性。结果高、低级别组各含18、18例SIF。高级别组存在Ⅲ~Ⅳ级软骨损伤者占比高于,OV及MME值(内侧半月板外缘垂线至胫骨平台软骨边缘垂线的距离)均大于低级别组(P均<0.05);组间半月板后角损伤分级差异有统计学意义(P=0.007)。SIF级别与软骨损伤分级、OV、MME值均呈正相关(r_(s)=0.710、0.765、0.540,P均≤0.01)。MME值与半月板损伤程度、撕裂范围均呈正相关(r_(s)=0.502、0.520,P均<0.01)。MME分级0、1、2级分别为4、19、13例,不同MME分级间软骨损伤分级、OV、MME值差异均有统计学意义(P均<0.05)。MME值与软骨损伤分级及OV均呈正相关(r s=0.451、0.579,P均<0.01)。结论SIF患者OV及软骨损伤与内侧半月板损伤模式及MME均存在相关性。Objective To observe the correlations of subchondral insufficiency fracture(SIF)of medial femoral condyle with medial meniscus injury pattern and medial meniscus extrusion(MME).Methods Data of 36 patients with clinically confirmed unilateral medial femoral condyle SIF were retrospectively analyzed.The patients were divided into low-grade and high-grade groups according to SIF grade.Cartilage injury,medial meniscus injury and MME were compared between groups,and the correlations of SIF grade with cartilage injury,osteonecrosis volume(OV)and MME were analyzed.Cartilage injury grade,OV and MME were compared between groups,and the correlations were explored.Results There were 18 cases in each group.The percentage of cartilage injury gradeⅢ—Ⅳ,OV and MME value(the distance between the vertical line of medial meniscus and the vertical line of tibial plateau cartilage)in high-grade group were greater than those in low-grade group(all P<0.05).Significant difference of injury grades of meniscus posterior horn was found between groups(P=0.007).SIF grade was positively correlated with cartilage injury grade,OV and MME value(r_(s)=0.710,0.765,0.540,all P≤0.01).MME value was positively correlated with meniscal injury degree and tear range(r_(s)=0.502,0.520,both P<0.01).There were 4,19 and 13 cases with 0,1 and 2 grade MME,respectively,and significant differences of cartilage injury grades,OV and MME values were found among different MME grades(all P<0.05).MME value was positively correlated with cartilage injury grade and OV(r s=0.451,0.579,both P<0.01).Conclusion In SIF patients,OV and cartilage injury were both correlated with medial meniscus injury pattern and MME.

关 键 词：膝关节 骨折 骨 软骨疾病 胫骨半月板损伤 

分 类 号：R684.7[医药卫生—骨科学] R445.2[医药卫生—外科学]