多层螺旋CT评估胫骨平台骨折内固定术后下肢力线及与膝关节功能的关系

Evaluation of Lower Limb Alignment and Its Relationship with Knee Function after Internal Fixation of Tibial Plateau Fracture by MSCT

本研究基于多层螺旋CT评估胫骨平台骨折内固定术后下肢力线变化及与膝关节功能的关系。回顾性分析125例接受内固定术治疗胫骨平台骨折患者临床资料,比较术后3 d患侧和健侧胫骨平台外侧后倾角(PA)、内翻角(TPA)、股胫角(FTA)、膝关节间隙宽度、平台塌陷,以及术后不同时间的患侧PA、TPA、FTA、膝关节间隙宽度及平台塌陷变化,观察不同膝关节功能患者患侧与健侧PA、TPA、FTA、膝关节间隙宽度差值、平台塌陷情况。结果显示,膝关节功能优、良、可+差患者术后6个月患侧与健侧PA、TPA、膝关节间隙宽度差值及平台塌陷依次增大(P<0.05);术后6个月患侧与健侧PA、TPA、膝关节间隙宽度差值及平台塌陷与膝关节功能呈负相关(P<0.05)。可见多层螺旋CT可准确评估胫骨平台骨折内固定术后下肢力线变化,其中PA、TPA、膝关节间隙宽度及平台塌陷与术后膝关节功能有关。

Based on multi-slice spiral CT this study evaluated the changes of lower limb alignment and its relationship with knee joint function after internal fixation of tibial plateau fractures.The clinical data of 125 patients with tibial plateau fractures treated with internal fixation were retrospectively analyzed.Compared the posterior tilt angle of tibial plateau(PA),tilt angle of tibial plateau(TPA),femoro tibia angle(FTA),knee joint space width and platform collapse between the affected side and the healthy side 3 days after operation.Compared the changes of PA,TPA,FTA,knee joint space width and platform collapse on the affected side at different times after surgery.And then compared the differences between the affected side and the healthy side of PA,TPA,FTA,knee joint gap width,and platform collapse in patients with joint function.The results showed that the PA,TPA,knee joint space width difference and platform collapse between the affected side and the healthy side in patients with excellent,good and fair+poor knee function increased in sequence at 6 months after operation(P<0.05).The difference of PA,TPA,knee joint space width and platform collapse between the affected side and the healthy side were negatively correlated with knee joint function(P<0.05).It can be seen that multi-slice spiral CT can accurately evaluate the changes of lower limb alignment after internal fixation of tibial plateau fractures.Among them,PA,TPA,knee joint space width and platform collapse are related to postoperative knee joint function.