螺旋CT及手术探查在踝关节损伤应用的重要性

The importance of the application of spiral CT and surgical exploration in ankle injury

目的:探讨螺旋CT及手术探查对踝关节损伤术前诊断及手术方案制定的应用价值。方法:回顾性分析自2006年6月至2010年1月对我院106例踝关节骨折病例行普通X线片检查、多层螺旋CT扫描及术中踝关节探查。结果:在106例踝关节骨折病例中,普通X平片漏诊15例,下胫腓联合分离损伤46例,关节内游离骨块18例,螺旋CT对骨折的诊断为100%,下胫腓联合分离损伤53例,关节内游离骨块30例,术中探查下胫腓韧带损伤为57例,关节内游离体的37例。结论:螺旋CT可多角度、多方位立体展示踝关节骨折的类型、骨折断端的移位情况,为临床手术治疗提供可靠信息,配合术中踝关节探查可以清除关节内游离体,减少或者延缓踝关节创伤性关节炎的发生。

Objective： To explore the value of spiral CT and surgical exploration on the ankle-joint injury preoperative diagnosis and surgical scheme. Methods： Retrospective analyze ordinary X-ray examination, multislice CT scanning and surgical exploration ankle of 106 cases of patients with ankle fractures who were treated in our hospital since June 2006-January 2010. Results： In 106 patients, ordinary X radiographs misdiagnosis for 15 cases, lower tibial joint separation injury for 46 cases, intra-articular bone block for 18 cases. Spiral CT for dialogue of fractures is 100%, lower tibial joint separation injury for 53 cases, intra-articular bone block 30 cases. Intraoperative exploration lower tibial ligament injury fpr 57 cases, intra-rticular bone block 37 for cases. Conclusion： Spiral CT can show types of ankle fractures, and the shift condition of fra -ctures, providing reliable information for clinical surgery, combined with intraoperative ankle exploration can remove intra-articular bone blocks, reducing or delay the occurrence of traumatic arthritis.