CT三维重建在胫骨平台骨折诊疗中的应用价值

目的探讨三维CT扫描对复杂胫骨平台骨折的分型及治疗方法选择的临床应用价值。方法 2006年4月至2008年3月对36例胫骨平台骨折患者的临床资料进行分析。其中男21例,女15例;平均44.5岁(23～56岁);左侧16例,右侧20例。术前均投照患侧膝关节正、侧位X线片及CT扫描,并进行后期三维重建。按照胫骨平台骨折Schatzker分型方法,对普通X线片与结合CT扫描的两种分型结果进行比较。结果 36例中7例改变原有分型(18.3%),有4例最终依据CT图像分型改变手术入路和内固定方法。36例中经CT证实合并胫骨髁间棘骨折共7例(18.3%),而普通X线检查仅发现较明显移位的4例髁间骨折。结论 CT三维重建对胫骨平台骨折分型及临床治疗方法的选择具有重要指导意义。

Effects of CT scan and three-Dimensional reconstruction on diagnosis and treatment of tibia plateau fractures

Objective To study the effects of CT scan and three-Dimensional reconstruction on treatment design and classification of tibia plateau fractures.Methods From April 2006 to March 2008,36 fractures with tibial plateau fractures were treated in our department.Their clinical data were studied retrospectively.There were 21 males and 15 females.Their average age was 44.5 years with a span from 23 to 56 years.16 fractures were on the left side and 20 on the right side.They all underwent anteroposteri and lateral radiography,CT scan and 3-D reconstruction.Their X-ray films and CT scans were both examined to find their fracture type according to the Schatzker＇s classification system.Results In this series,the classifications for seven fractures（18.3%）were corrected according to the CT findings.As a result,initial internal fixation plans were changed for four fractures of them.Conclusions Although it is expensive,CT scan should serve as a routine examination before operation because it has significant effects on treatment plan,diagnosis and classification of tibial plate fractures.