螺旋CT三维重建对老年股骨颈骨折分型的价值

Clinical Value of Spiral CT Scanning and Three-Dimensional Reconstruction on Classification and Treatment of Femoral Neck Fracture

目的:探讨螺旋CT扫描及三维重建对股骨颈骨折分型及治疗的价值。方法:按照Garden分型标准,对355例股骨颈骨折患者应用X线片和64排螺旋CT扫描分别进行分型制定相应的治疗方案。结果:单纯X线检查与结合螺旋CT扫描及三维重建成像重新分型相比,两组行骨折内固定需要手术所占比例分别为23.24%和22.94%,差异无统计学意义(P>0.05),骨折不愈合病例所占比例分别为27.78%和5.88%,两组股骨头坏死病例所占比例分别为22.22%和2.94%,差异均有统计学意义(P<0.05)。结论:CT扫描及三维重建成像可以全面、准确的显示股骨颈骨折的情况,有助于骨折的正确分型,选择合理的治疗方法,降低股骨颈骨折后骨折不愈合及股骨头坏死的发生比率。

Objectives To determine the clinical value of spiral CT scanning and three-dimensional recon-struction（TDR）on the classification and treatment of femoral neck fracture（FNF）.MethodsA total of 355patients（132 males and 223 females） aged from 65 to 85 years（mean 73 years） with FNF treated from August2005 and December 2012 were recruited. According to the Garden classification for FNF, all patients were clas-sified after X-ray and 64-slice CT examinations and treated accordingly.ResultsCompared with the exami-nation only with X-ray, the examination combining the spiral CT scanning and TDR imaging had statistic signif-icance in the nonunion of the femoral neck and also had the statistic significance in the avascular necrosis foraged FNF patients.ConclusionTDR is helpful for the correct classification of FNF, the reduction of misdiag-nosis and the determination of the reasonable treatment for its excellent presentation in the details and displace-ments of the FNF and the insertion of occult fracture. Consequently, TDR has vital significance to the clinicaltreatment for FNF.