骨盆骨折X线表现及轴向CT相关性研究

目的探讨骨盆骨折时骨盆前后位、出口位、入口位X线表现及轴向CT表现的差异,确定不同部位骨盆骨折投照的最佳位置。方法回顾性分析了55例骨盆骨折患者骨盆前后位、出口位、入口位X线片及轴向CT片。将骨折表现程度分为四个等级。分别观测同一部位骨折在不同位置X线片及CT上的表现程度。结果耻骨联合分离程度在各种投照位置上无明显差异。耻骨支、耻骨体、坐骨、骶孔和L5横突,移位程度在出口位上表现最明显。骶髂关节分离,骶骨翼、髂嵴骨折在入口位上表现最明显。骶骨压缩骨折,半骨盆向后移位,水平旋转不稳在入口位X线片上最明显。垂直旋转不稳在出口位片上最明显。CT在诊断骶髂关节分离及骶骨骨折有独特价值。结论骨盆骨折应首先摄前后位X线片,根据骨折部位,进一步摄入口位、出口位X线片。并根据骨折的表现判断其稳定性,指导临床治疗。CT在诊断骶骨骨折,骶髂关节分离有独特价值。

Correlation Study on X - ray Examination and Axial Computed Tomography Imaging in Pelvic Fracture

Objective To study the different radiographic projections of the pelvis and the corresponding anatomic landmarks,and select the best projection for the diagnosis of pelvic fractures.Methods From January 1999 to June 2004,55 patients with pelvic fractures were observed retrospectively.The anteroposterior,inlet,outlet,Judet views,and axial computed tomography images were evaluated.The fracture manifestations were divided into 4 degrees and were observed in different radiographic projections.Results There was no significant difference in separation of pubic symphysis in different projections position.The fractures of pubis,ischium,sacrum and L_5 transverse process were most apparent on outlet view.The separation of sacroiliac joint and iliac fracture were most apparent on inlet view.The compression fracture of sacrium,hemipelvis posterior displace and coronal plane rotational instability was most apparent on inlet view.The sagittal rotational instability was apparent on outlet view.The CT had special value for diagnosing disruption of sacroiliac joint and sacral fracture.Conclusion When the hip is injuried,the anteroposterior view X-ray should be taken first followed by the inlet view and the outlet according to the sites of the fractures.CT is very important in diagnosing sacral fracture and disruption of sacroiliac joint.