螺旋CT三维重建在复杂骨关节骨折中的应用

目的：研究螺旋CT三维重建在复杂的骨关节骨折中的应用价值。方法：本组42例骨折（6例胫骨平台骨折，3例Pilon骨折，24例跟骨骨折，3例脊柱骨折，6例骨盆骨折）在普通X线摄片的基础上进行SCT三维重建处理。结果。SCT三维重建图像直观，立体，全,面地显示了复杂骨关节骨折的形态和特点，根据SCT三维重建图像，胫骨平台骨折进行Schatzker分型，Pilon骨折进行Rueedi分型，胫骨平台骨折和Pilon骨折的再分型和分型补充为选择切口入路和手术方法提供了指导；跟骨骨折进行Sanders分型且指导手术；对脊柱，骨盆骨折和类型和预后进行了判断并在其指导下治疗。结论：螺旋CT三维重建能清楚地显示普通X线摄片所不能直接清楚显示的骨关节骨折的情况，对术前骨折分型，治疗方案及手术入路的选择有一定的价值。

Application of Three-dimensional Spiral CT Reconstruction to Fracture of Complicated Bone and Joint

Objective　To study the value of spiral CT and three-dimensional reconstruction on fracture of complicated bone and joint.Methods　Spiral CT and 3D reconstruction were used in 42 fractures(6 tibial plateau fractures and 3 Pilon fractures and 24 calcaneus fractures and 3 spine fractures and 6 pelvis fractures) after plain radiographs.Results　The structure and feature of complicated bone and joint could be presented on the SCT and 3D images. Under the guide of SCT and 3D images, tibial plateau fractures and Pilon fractures were re-classified by Schatzker's and Rüedi's classification and were given the complement of new classification, calcaneus fractures were classified by Sanders' classification and operated, spine fractures' and pelvis fractures' types and prognoses were judged and treated.Conclusion　Spiral CT and 3D reconstruction can show clearly complicated bone and joint fractures which can not be displayed clearly by common X-rays. SCT and 3D reconstruction is a useful technique for the diagnosis and surgical planning of the complicated bone and joint fractures.