CT三维重建在股骨粗隆间骨折治疗中的应用价值

Use of CT three-dimensional reconstruction in treatment of intertrochanteric fractures

目的:探究CT三维重建在股骨粗隆间骨折治疗中的应用与价值。方法:选择2012年5月-2014年5月我院收治的108例股骨粗隆间骨折者为研究对象。将其分为两组,每组54例。对照组患者在术前拍摄X线平片,并在术后实施股骨近端CT三维重建。观察组患者在手术前后均进行股骨近端CT重建。比较两组患者骨折具体数目,股骨粗隆间折端稳定性以及骨皮质连续性情况。结果:和对照组相比,观察组患者的骨折皮质连续性与稳定性检出精准性较强(P<0.05);和对照组相比,观察组患者的测量准确率显著较高(P<0.05);和术中比较,差异无统计学意义(P>0.05);以相同手术方式为基础,和对照组相比,观察组患者术后髋关节畸形,关节功能,运动范围和疼痛情况显著较好(P<0.05)。结论:对于股骨粗隆间骨折患者,在治疗过程中使用CT三维重建的方式进行检查,可取得满意效果,能够精准显示出骨折皮质连续性与稳定性,骨块数量,方便后续治疗方案制定,有利于患者疾病转归,值得进一步推广。

Objective：To determine the use and value of CT three-dimensional reconstruction in the treatment of intertrochanteric fractures. Methods：A total of 108 patients with intertrochanteric fractures,who were hospitalized in our hospital between May 2012 and May 2014, were included as the subjects in the study. All patients were divided into two groups （n=54 each）. The X-ray plain film was performed in the control group before the operation, and the CT three-dimensional reconstruction of proximal femur was performed after the operation. The CT three-dimensional reconstruction of proximal femur was performed before and after the operation in the study group. The specific number of fractures, the stability of the intertrochanteric fold side and the continuity of cortical bone were compared between the two groups. Results：Compared with the control group,the detection precision of the fracture cortical continuity and stability in the study group was higher （ P〈0. 05 ） . Compared with the control group, the measurement accuracy in the study group was significantly higher （ P〈0.05） . There was no significant difference in the intraoperative measurement accuracy between the two groups （P〉0.05）. Based on the same operation method,the postoperative deformity of hip joint,joint function, range of motion and pain outcomes in the study group were significantly better compared with those in the control group （ P〈 0. 05 ） . Conclusion：For patients with intertrochanteric fractures, using CT three-dimensional reconstruction in the treatment for examination, can achieve satisfactory effect, and can accurately show the fracture cortical continuity and stability,and the number of bone fragments. It is convenient for the establishment of the subsequent treatment protocol,and favors for the prognosis of the disease,which justifies widespread use.