列车乘务员疲劳骨折38例临床及影像学分析

目的：通过对列车乘务员疲劳骨折的临床表现、X线与CT征象进行分析,提高对疲劳骨折的认识.方法：回顾性分析38例列车乘务员疲劳骨折资料,对骨折原因、骨折部位及X线与CT表现进行归纳总结.结果：本组38例均为年轻女性列车乘务员,发生于胫骨3例（7.9%）,第2跖骨21例（55.3%）、第3跖骨14例（36.8%）.不全性疲劳骨折31例（81.6%）,表现为局部皮质增厚,内可见横行短骨折线,周围骨质略有吸收,可有骨痂形成,CT扫描,在长骨可见典型的＂双皮质征＂.完全性疲劳骨折7例（18.4%）,表现为骨折线贯穿骨骼,断端分离,断面整齐、致密.结论：疲劳骨折中后期X线与CT表现较具特征性.要减少列车乘务员疲劳骨折的发生,预防疲劳损伤积累是关键.

Analysis of clinical performance and imageology of 38 cases of trainmen with fatigue fracture

Objective： To improve the knowledge of fatigue fracture by analyzing the relevant clinical performances, X- ray and CT- scan. Methods： 38 cases of fatigue fracture were analyzed, the cause was probed into, the outbreak part, X- ray and CT- scan expression were summarized. Results： In the 38 cases, there were young female trainmen all, 3 hurt in the tibia（7.9% ）, 21 in the second metatarsal bone（55.3 % ）, 14 in the third metatarsal bone（36.8 % ）. According to the 31 incomplete fatigue fracture cases（81.6 % ）, partial cortex incrassation was obvious and transverse short fracture lines were found insides. The surrounding bone substance had been absorbed slightly and formed into bone scab. By CT scanning, typical two layer cortex of the bones＇could be found in the long bone.As symptoms of the other 7 complete fatigue fracture cases（ 18.4% ） ,fracture lines ran through thebone, the broken parts separated and the sections were tidy and fine. Conclasion： In the mid/later period,the X- ray/CT- scan represents characteristic peffomame.To reduce the occtrrrence af the trainmen fatigue fracture, prevention of fatigue damage accumulation is the key.