股骨颈骨折移位程度的CT评估

Evaluate the displacement of femoral neck fracture by CT imaging

目的初步建立股骨颈骨折移位程度的CT评估方法。方法通过对93例股骨颈折CT影像资料地分析,确定测量三个指标即远端骨折片轴线夹角,远近端骨折线长度差值以及远近端骨折线重叠程度,分别反映骨折的成角移位,旋转和纵向移位以及侧方移位。对所有CT测量值进行量化评分,依据评分值对所有病例的移位程度做出评估及分组,对所有CT测量值进行量化评分,依据评分值对所有病例的移位程度做出评估及分组,分别为无移位组(0～1)分,轻度移位组(2～4分),中度移位组(5～8分)和重度移位组(>8分)四个组别。并对各组中CT评估的骨折移位程度与相应的Garden分型进行分析比较。结果 93例中无移位组11例,轻度移位组22例,中度移位组35例,重度移位组25例。16例GardenI,II型患者中,11例评分为0分,为真正的无移位骨折,5例评分分别为2和1分,有轻度移位。77例GardenIII,IV型患者中,轻度移位组17例,中度移位组35例,重度移位组25例。结论 CT影像资料更准确全面地评估股骨颈骨折的真实移位程度。

Objective To preliminarily establish a method to evaluate the displacement of femoral neck fractures was analyzed,and three indexes were defined to evaluate the displacement of the fractures.Methods Analyse the Ct imaging of 93 patients with femsral neck fractrure.The first index was the angle of the two axis of the proximal and distal fragment.which indicates the angular displacement of the fracture.The second index was difference of length of the proximal and distal fracture line,which indicates the rotational and axial displacement of the fracture;and the third index was the overlapping length of the proximal and distal fractures lines,which indicates the lateral displacement of the facture.After the CT indexes were quantified and scored,all the cases were classified to 4 groups in accordance with the evaluating scored,the 4 classified groups were groups are with no displacement（scored 0 or 1）,with mind displacement（scored 2 to 4）,with moderate displacement（scored 2 to 4）,with moderate displacement（scored 5 to 8）and with severe displacement（scored over 8）.Then compare the group by evaluating CT imaging with the classification of Garden and analyze.ResultsAmong all of the 93 cases,11 cases were no displacement,22 cases were mild displacement,35 cases were modeate displacement and 25 cases were sever displacement.Among the 16 cases that,the classification was Garden I or II,the score of 11 cases was zero,these were really non-displacement.Among the 77 cases that the classification was Garden III or IV,17 cases were mild displacement,35 cases were moderate displacement and 25 cases were severe displacement.ConclusionThe displacement of femoral neck fractures can be evaluated more accurate and comprehensive by CT imagings.