改良日出位X线片在后交叉韧带损伤诊断中的应用价值

Diagnosis of Posterior Cruciate Ligament Injury by Stress Radiography Using Modified Sunrise View Technique

目的探讨改良日出位X线片在评估后交叉韧带(PCL)损伤中的应用价值。方法对43例确诊为单纯PCL损伤的患者摄取改良日出位X线片,在X线片上对双膝胫骨平台前缘相对于股骨髁前缘距离进行测量和对比,计算其差值即PCL损伤膝胫骨近端后移位值,然后进行关节镜检查排除合并前交叉韧带损伤(ACL),并进行PCL部分断裂和完全断裂的甄别诊断和分组记录,对改良日出位X线片测量结果进行统计比较。结果其中PCL不完全断裂19例,胫骨平台向后移位的平均值是(6.2±1.9)mm;PCL完全断裂24例,胫骨平台向后移位平均值是(11.8±2.3)mm;前后平均值比较,P<0.01。结论膝关节改良日出位X线片在PCL损伤的检查和诊断中有优越的实用价值。该方法操作简单,结果准确可靠,可重复性强,经济实用,可作为PCL损伤的常规检查方法和重要诊断依据。

Objective To discuss the value of stress radiography using the modified sunrise view technique with the knee in the diagnosis of posterior cruciate ligament （PCL） injury. Methods Forty-three patients with simple and unilateral PCL injury were enrolled in stress radiography using the modified sunrise view technique with the knee. The quantity of posterior tibia/subluxation in knees with PCL ruptures was measured by the radiograph.Results In knees with complete PCL ruptures （24 patients）, the mean posterior tibial subluxation increase was （11.8±2.3） mm while in knees with part PCL ruptures （19 patients）, the mean posterior tibial subluxafion increase was （6.2±1.9） ram, P〈0.01. Conclusion Modified sunrise view technique with the knee for the diagnosis of PCL injury is practical and the technique is easy to grasp with the accurate results and high repeatability.