三维CT评估对老年人股骨粗隆间骨折治疗的影响研究

A study on the effect of three-dimensional CT evaluation on the curative effect of femoral intertrochanteric fracture in the elderly

目的 分析三维CT评估对老年人股骨粗隆间骨折治疗的影响.方法 78例股骨粗隆间骨折老年患者,依据患者意愿分为X线片组和三维CT组,每组39例.X线片组采用X线片拍摄进行检查,三维CT组采用三维CT重建技术进行检查.比较两组患者术前骨折分型、术后Harris髋关节评分、及术后3个月骨折复位情况[股骨横截面面积(CSA)、股骨颈前倾角(FNAA)、颈干角(NSA)].结果 三维CT组患者骨折端不稳定占比79.49%高于X线片组的51.28%,差异具有统计学意义(P<0.05).三维CT组患者术后的Harris髋关节评分(90.51±4.21)分高于X线片组的(81.67±3.62)分,差异具有统计学意义(P<0.05).三维CT组患者术后的CSA(1.40±0.23)cm2大于X线片组的(1.17±0.14)cm2,FNAA(14.60±3.02)°、NSA(123.69±6.74)°均小于X线片组的(16.60±3.50)、(128.21±7.67)°,差异均具有统计学意义(P<0.05).结论 三维CT评估利于医师分辨股骨粗隆间骨折类型,为临床选择适当的手术方式作出重要指导,提高治疗效果.

Objective To analyze the effect of three-dimensional CT evaluation on the curative effect of femoral intertrochanteric fracture in the elderly.Methods A total of 78 elderly patients with femoral intertrochanteric fracture were divided into X-ray group and three-dimensional CT group according to their wishes,with 39 cases in each group.The X-ray group was examined by X-ray photography,and the threedimensional CT group was examined by three-dimensional CT reconstruction technology.The preoperative fracture classification,postoperative Harris hip score and postoperative 3 months fracture reduction[cross-sectional area(CSA),femoral neck anteversion angle(FNAA),neck shaft angle(NSA)]were compared between the two groups.Results The proportion of unstable fracture 79.49%of three-dimensional CT group was higher than that of X-ray group 51.28%,and the difference was statistically significant(P<0.05).Postoperative Harris hip score(90.51±4.21)points of three-dimensional CT group was higher than that of X-ray group(81.67±3.62)points,and the difference was statistically significant(P<0.05).The postoperative CSA(1.40±0.23)cm2 of threedimensional CT group was greater than that of X-ray group(1.17±0.14)cm2,and FNAA(14.60±3.02)°and NSA(123.69±6.74)°were less than those of X-ray group(16.60±3.50)and(128.21±7.67)°,and the difference was statistically significant(P<0.05).Conclusion Three-dimensional CT evaluation is helpful for doctors to distinguish the types of femoral intertrochanteric fractures,and provide important guidance for clinical selection of appropriate surgical methods,so as to improve the treatment effect.