外踝撕脱骨折的X线摄片方法

X-ray projections for avulsion fractures of the lateral malleolus

目的 探讨由前距腓韧带 (ATFL)和跟腓韧带 (CFL)所致撕脱骨折显像清楚而不重叠的X线投照方法。方法 在标本足上用钢丝对ATFL和CFL外踝起点捆扎后进行踝和足的正斜位X线投照 ,并对ATFL和CFL起点模拟撕脱骨折用钡剂强化其影像后行各种特殊位投照。结果 ATFL起点钢丝环在足跖屈 45°、外旋 15°足斜位片上完全闭合 ,模拟ATFL撕脱在此位置能清楚显示骨折而不重叠 ;CFL起点钢丝环在踝内旋 45°斜位片上完全闭合 ,模拟撕脱骨折在此位置清楚显示而不重叠。结论 足跖屈 45°、外旋 15°足斜位片能清楚显示ATFL撕脱骨折 ,踝内旋 45°斜位片能清楚显示CFL撕脱骨折。

Objective To explore methods of getting clear but without superimposition X ray projections of the lateral malleolus for avulsion fractures caused by anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL).Methods The examined feet were tied with soft wire around both ATFL and CFL attachments on the lateral malleolus,and radiographs of the prepared feet were taken on neutral position and tilt positions.The avulsion on the ATFL and the CFL attachment were imitated.To make the film clearer, barium sulfate was used,and radiographs were taken on several predesigned position. Results The marker wire at insertion of the ATFL taken at 15° external rotation with 45°of plantar flexion appeared as an ellipse and the imitated avulsion fractures of the ATFL were clearly seen without superimpositipon at these angles,the marker wire at insertion of the CFL taken at 45° internal rotation and tilt position appeared as an ellipse and the imitated avulsion fracture of the CFL were clearly seen without superimposition at these angles.Conclusion The avulsion fractures of the ATFL can be clearly seen without superimposition at 15° external rotation with 45° of plantar flexion of foot,and the avulsion fracture of the CFL also can be clearly seen without superimposition at 45° internal rotation and tilt position of ankle.