三维CT重建在肩胛骨骨折中的应用

The application of three-dimensional CT image reconstruction in scapular fractures

目的 探讨三维CT重建在肩胛骨骨折治疗中的指导意义。方法 7例肩胛骨粉碎性骨折患者接受X线、CT扫描、三维CT重建检查 ,对骨折的严重程度进行评估 ,并据此制定最佳治疗方案。结果 7例中 ,4例累及肩胛颈 ,2例累及肩胛颈和肩胛盂 ,1例伴锁骨骨折 ;6例接受手术治疗。所有患者均获得随访 ,随访时间 3个月～ 2年 6个月 ,骨折平均愈合时间 7～ 10周 ,肩关节功能恢复良好。结论 三维CT重建能多方位、立体、全面地显示肩胛骨骨折部位、程度。对骨折手术方案的制定、手术入路和内固定的选择有很强的指导意义。

Objective To study clinical significance of three dimensional CT image reconstruction in the management of scapular fracture. Methods 7 cases of scapular comminuted fracture were examined by X ray films, CT scan and three dimensional CT reconstruction. Based on the images, all fractures were classified and evaluated in order to select the optimal treatment. Results 4 cases involved scapular neck fracture, 2 involved scapular neck fracture and scapular cavity fracture, and 1 involved clavicle fracture. 6 cases were performed operations. The patients were followed up from 3 to 30 months. Bony healing achieved in 7 to 10 weeks. The functional recovery of shoulder joint was satisfactory. Conclusion Three dimensional CT reconstruction can display distinctly the location and degree of fracture from arbitrary direction, which is useful for classification of fractures, selection of operative approach and internal fixation.