MSCT诊断跟骨关节内骨折并发腓骨肌腱脱位

MSCT in diagnosis of peroneal tendon dislocation accompanying intra-articular calcaneal fractures

目的探讨MSCT诊断跟骨关节内骨折并发腓骨肌腱脱位的价值。方法收集我院PACS系统内162只跟骨关节内骨折足的CT图像,对图像进行回顾性重建,分析是否存在腓骨肌腱脱位,计算腓骨肌腱脱位的发生率,测量跟骨宽度分析跟骨宽度与腓骨肌腱脱位的关系,同时观察跟骨骨折治疗后CT图像上原脱位的腓骨肌腱位置情况。结果162只跟骨关节内骨折足,合并腓骨肌腱脱位28只,发生率为17.28%;合并腓骨肌腱脱位骨折足的跟骨结节外侧突后缘至载距突内侧面的宽度及至载距突后缘处的跟骨宽度分别为(5.04±0.45)cm、(4.22±0.42)cm,腓骨肌腱骨折足的结果分别为(4.80±0.53)cm、(3.77±0.44)cm,差异均具有统计学意义(P均<0.05),说明腓骨肌腱脱位与跟骨宽度增加有关。CT随访合并腓骨肌腱脱位骨折足10只,均行跟骨切开复位内固定手术而脱位的腓骨肌腱均未特殊处理,其中腓骨肌腱自动复位2只,仍处于脱位状态8只。结论 MSCT对腓骨肌腱脱位的诊断、治疗指导及疗效监测具有重要的临床应用价值。

Objective To explore the value of MSCT in diagnosis of peroneal tendon dislocation accompanying intra-articular calcaneal fractures.Methods Totally 162 calcaneal fractures presenting in our institution were enrolled.The reconstructed images were reviewed to determine whether or not there was peroneal tendon dislocation.The prevalence of peroneal tendon displacement was calculated.The association of tendon displacement with heel width were evaluated and whether peroneal tendon remaining displaced according to post-treatment images were detected.Results Peroneal tendon displacement was identified in 28（17.28%）of the 162 calcaneal fracture feet.The measurement of calcaneal width of posterior edge of sustentaculum and tuberosity posterior to the sustentaculum in calcaneal fractures with peroneal tendon displacement were（5.04±0.45）cm and（4.22±0.42）cm respecpectively,and which in feet without tendon diaplcacement were（4.80±0.53）cm and（3.77±0.44）cm,There were statistically significant difference between those two items in the displaced and normal peroneal tendon in acute intra-articular calcaneal fractures（both P〈0.05）,which suggested the presence of tendon displacement was significantly associated with heel width.Ten calcaneal fracture feet with tendon dislocation underwent operative treatment that did not include specific treatment of the tendons,2dislocated peroneal tendons were back to the normal location,8were still in dislocation.Conclusion MSCT has a great clinic application value in diagnosing dislocation of peroneal tendons.