髋臼骨折的X线及CT诊断分析

目的：总结123侧髋臼骨折的Judet-Letoumel分类表现。比较X线平片检查与CT检查在髋臼骨折诊断中的价值。方法：本组患者109例，其中14例为双侧髋臼骨折，共123侧髋臼骨折，全部经手术证实并行X线平片检查，CT检查，其中36例行CT三维重建。由有经验的医师分别单独依据X线资料，单独依据CT检查资料，或依据X线结合CT资料对骨折进行分析并依据Judet-Letoumel分类法分型，然后由2位手术医师共同根据手术中所见作出最终诊断，比较诊断符合情况。同时对髋臼内能否发现碎骨块进行记录比较。结果：单独依据X线平片诊断符合112例(91．1％)，依据CT资料诊断符合114例(92．6％)，依据X线平片与CT结合诊断符合120例(97．6％)。前两组比较无统计学差异，X线平片与CT结合组与前两组比较有显著性差异。对髋臼内骨折碎块判断：本组123例患者中有77例手术发现髋臼内合并有碎骨片，平片发现32例，显示率为41．5％。CT显示73例，显示率为93．6％，两者比较有显著性差异。结论：X线检查与CT检查对于髋臼骨折Judet-Letoumel分类诊断符合率无明显区别，两者结合可提高诊断准确率。CT检查对髋臼内骨折碎块的诊断价值优于X线平片。

The comparison of plain radiographs and CT on the diagnosis of acetabular fractures

Objective:To summarize the Judet-Letournel classification system of acetabular fractures and to compare the reliability of plain radiographs with computed tomography.Methods:123 cases of acetabular fractures were studied. Plain radiographs and computed tomography were taken in all patients. Surgeons who specialized in acetabular fractures classify the fractures on the basis of the plain radiographs only or on the basis of the computed tomographs only or radiographs combined with computed tomographs. The last diagnosis were made intraoperatively by two treating surgeons.Results:The classification diagnosis were correct in 112 cases ( 91.1%) on the basis of the radiographs only, 114 cases (92.7%) on the basis of the computed tomography only, 120 cases ( 97.6%) on the basis of the radiographs combined with computed tomography,there were no statistics difference between the plain radiographs and the computed tomography. Small fracture fragments were find intraoperatively in 77 cases, 32 cases were identified with radiographs, 73 cases were identified with computed tomography, there were statistics difference between two groups.Conclusion:Both plain radiographs and computed tomographs were reliable to the Judet-Letournel classification, It is more reliable for diagnosis to combine plain radiographs and computed tomography. Computed tomography appears to be more sensitive in detecting small articular fracture fragments.