CT三维重建在AO-C型桡骨远端骨折复位固定质量评估中的应用

目的探讨CT三维重建技术在AO-C型桡骨远端骨折术后复位、内固定质量评估中的应用,及其指导手术操作的临床价值。方法回顾性分析自2012-05—2016-02采用切开复位钢板内固定治疗的56例AO-C型桡骨远端骨折,术后分别采用腕关节正侧位X线片及CT三维重建观察骨折复位及内固定质量。结果 X线片显示1例未达到解剖复位,而CT三维重建显示11例未达到解剖复位;X线片与CT三维重建显示C1型骨折复位质量差异无统计学意义(P0.05);而CT三维重建显示C2、C3型骨折复位质量较X线片显示的差,差异有统计学意义(P0.05)。X线片显示4例内固定位置合适,而CT三维重建显示17例内固定位置不合适;X线片与CT三维重建显示C1型骨折内固定质量差异无统计学意义(P0.05);而CT三维重建显示C2、C3型骨折内固定质量较X线片显示的差,差异有统计学意义(P0.05)。结论 AO-C型桡骨远端骨折复位内固定术后进行骨折复位及内固定质量的评估中,CT三维重建优于X线片。

Application of 3D-CT reconstruction in quality evaluation of postoperative AO type C distal radius fractures

Objective To explore the application of 3D-CT reconstruction in postoperative quality assessment of AO type C distal radius fractures and the value of clinical application in the operation guidance.Methods Fifty six cases of type C distal radius fractures from May 2012 to Feb.2016 were retrospectively analyzed.All cases were treated by open reduction internal fixation with locking plate.Postoperative antero-posterior and lateral position X-ray and 3D-CT reconstruction of the wrist joint were studied and the quality of fracture reduction and implant quality were compared and analyzed.Results In the evaluation of the quality of reduction,X-ray showed that 1 case did not achieve anatomical reduction,while CT reconstruction showed that 11 cases did not achieve anatomical reduction.The X-ray and 3D-CT reconstruction of C1 type fracture reduction quality had no significant difference(P ＞0.05);while the 3D-CT reconstruction showed that the fracture reduction quality of C2 and C3 type fractures was worse than that of X-ray,the difference was significant (P ＜0.05).In the fixed quality evaluation,the X-ray showed that 4 cases of internal fixation were appropriate,and the 3D-CT reconstruction showed that 17 cases were not suitable.There was no significant difference in the internal fixation quality of C1 type fracture between X-ray and CT (P ＞0.05);3D-CT reconstruction showed that the quality of C2 and C3 type fractures was less than that of X-ray,the difference was statistically significant (P ＜0.05).Conclusion In the evaluation of fracture reduction and internal fixation quality of AO type C distal radius fractures after reduction and internal fixation,3D-CT reconstruction is superior to X-ray.