CT在髋臼骨折中的应用

The application of computed tomography examination in acetabular fractures

目的 探讨CT检查在髋臼骨折的诊断、治疗上的临床意义。方法 对我院 2 0 0 1年 1月到 2 0 0 2年 6月间因髋臼骨折而收住院的 6 6例有完整平片和CT的病例进行回顾性分析 ,逐个对两者在放射学上的影像结果进行仔细分析并作横向对照。结果 6 6例中 ,有 6例经CT检查而更改诊断。对于边缘压缩骨折、关节内游离体、股骨头压缩、骶髂关节损伤和坐骨结节骨折 ,平片和CT的阳性诊断例数之比分别为 3:17、7:2 9、6 :15、0 :5和 1:5 ,并且CT能多层次清晰显示髋臼顶部的骨折形态。结论 CT对于平片是不可缺少的有效补充检查 ,对于髋臼负重区的损伤判断 ,关节面的边缘压缩骨折 ,关节内游离体 ,股骨头骨折 ,骨盆后方骨折有决定性作用 ,能进一步明确并完善诊断 ,有效指导治疗。故CT检查应与正位、髂骨斜位和闭孔斜位X线片一并作为髋臼骨折的常规放射学检查 。

Objective To study the clinical significance of computed tomography(CT) in diagnosis and treatment of acetabular fractures. Methods The plain and CT films of the 66 cases of acetabular fracture from January 2001 to June 2002 were analyzed retrospectively,and the radiological characteristics and results were compared to each other. Results The diagnosis of 6 cases were changed after CT examination,and the occurrence ratio of marginal impaction,free body in joint,femoral head fracture ,sacro iliac injury and ischial tubersoity fracture involvement were 3:17,7:29,6:15,0:5 and 1:5 in plain and CT examination respectively. Conclusions CT examination has the determinative role in detecting weight bearing zone,marginal impaction,free body,femoral head fracture,sacro iliac injury,etc.,and for completing the diagnosis and guiding the treatment.It should be the routine examination just as the three standard plain examinations in acetabular fractures,and should be carefully read.