CT三维重建在髋臼骨折诊断治疗中的作用

Three dimensional computed tomography in diagnosis and treatment of acetabular fracture

目的探讨CT三维重建在髋臼骨折诊断治疗中的意义,以提高髋臼骨折的诊疗水平。方法对57例有移位的髋臼骨折进行术前CT三维重建,明确骨折的类型,然后制定手术方案和选择最佳的手术入路。结果57例患者均获得12个月～6年9个月的随访,平均26个月。按Matta的疗效评定标准,临床标准优43例,良6例,可8例,优良率85.96%;X线标准:优44例,良6例,可7例,优良率87.72%。结论CT三维重建逼真地显示了损伤的髋臼立体表面形态,有助于判断髋臼骨折的部位、类型和损伤程度,对手术入路的选择和手术复位固定的方法具有指导作用。

Objective To discuss the significance of three dimensional computed tomography in the improvement of clinical diagnosis and therapy of acetabular fracture. Methods 3D CT was performed for 57 cases of displaced acetabular fracture before operation in order to understand the fracture type, design the operation scheme and select proper operative approaches. Results The 57 cases were followed up for 12 to 81 months. Curative effects were assessed according to Maffas evaluation system. By clinic criteria, 43 cases were excellent, 6 cases good, and 8 cases acceptable. By X ray criteria, 44 cases were excellent, 6 cases good, and 7 cases acceptable. Conclusion As 3D CT clearly reveals the stereoscopic injured surfaces, it is helpful in determining position and type of the fracture and severity of the injury so that it can facilitate selection of surgical approach, reduction and appropriate internal fixation during operation.