髌上囊积液在胫骨平台骨折诊断中的价值

Diagnostil value between tibial plateau fracture and suprapatellar capsule effusion

目的通过对胫骨平台骨折与髌上囊积液关联性研究,指导外伤后膝关节DR影像读片,减少胫骨平台骨折漏诊。方法回顾本院2019—2020年膝关节外伤有髌上囊积液病例777例,年龄2~79岁,其中DR摄片+CT检查348例,DR摄片+MRI检查273例,DR摄片+CT检查+MRI检查156例。探讨胫骨平台骨折与髌上囊积液的关联性。结果髌上囊积液而未见骨折56例,占比7.2%。髌上囊积液有骨折721例,占比92.8%;其中非胫骨平台骨折182例(股骨髁、髌骨、腓骨头骨折定义为非胫骨平台骨折),占比25.2%;胫骨平台骨折539例,占比74.8%;胫骨平台骨折Schatzker分型,Ⅰ型骨折86例,Ⅱ型骨折118例,Ⅲ型骨折87例,Ⅳ型骨折84例,Ⅴ型骨折63例,Ⅵ型骨折101例。结论有明确外伤史,髌上囊积液患者中胫骨平台骨折占比很高,高达69.3%;分析DR影像时,有髌上囊积液,而无髌骨、股骨等部位明显骨折时应重点分析胫骨平台影像,识别骨折,减少漏诊。

Objective To study the relationship between tibial plateau fracture and suprapatellar capsule effusion, guide post-traumatic knee joint DR image reading to reduce tibial plateau fracture leakage. Methods Seven hundred and seventy-seven cases of suprapatellar cyst effusion from 2019 to 2020 were reviewed,age 2~79, of them CT 348,DR film MRI 273 cases, DR film CT examination MRI examination 156 cases.To investigate the relationship between tibial plateau fracture and suprapatellar capsule effusion. Results There were 56 cases without fracture, accounting for 7.2% of them. There were 721 cases of fracture in suprapatellar sac effusion, accounting for 92.3% of the total. Among them, 182 non-tibial plateau fractures(femoral condyle, patella, fibula head fractures defined as non-tibial plateau fractures) accounted for 25.2%. There were 539 cases of tibial plateau fractures, accounting for 74.8% of them;Schatzker types of tibial plateau fractures, 86 type Ⅰ fractures, 118 type Ⅱ fractures, 87 Type Ⅲ fracture, 84 typeⅣ fracture, 63 type Ⅴ fracture, 101 type Ⅵ fracture. Conclusion There is a clear history of trauma, the proportion of tibial plateau fracture in patients with suprapatellar sac effusion is high, Up to 69.3 per cent;When analyz-ing the DR image, there is suprapatellar sac effusion, but no obvious fracture of patella and femur, we should focus on the analysis of tibial plateau image, identify fracture and reduce missed diagnosis.