摘要
目的:探讨后pilon骨折中累及胫骨腓切迹的后外侧骨折块的发生率及CT形态学特点。方法:回顾性研究2013年5月至2018年5月中日友好医院骨科收治的31例后pilon骨折患者的CT图像及临床资料,年龄20~68岁,平均42岁;男17例,女14例;左侧13例,右侧18例。统计患者累及胫骨腓切迹的后外侧骨折块的发生率,并测量其骨折线的轴向角度、受累面积、骨折块高度、矢状位角度等形态学参数。结果:在31例患者中均检测到存在累及腓切迹的后外侧骨折块,在后pilon骨折块中的发生率为100%。累及胫骨腓切迹骨折块的骨折线偏于冠状位,骨折线轴向角度为20.25°±9.48°,累及下胫腓联合的骨折块面积占整个胫骨远端关节面面积的比例为15.78%±6.75%,骨折块高度为(36.59±10.70)mm,骨折线矢状位角度为18.37°±5.45°。结论:所有后pilon骨折均存在累及胫骨腓切迹的后外侧骨折块,关节面骨折块累及的关节面面积较小,骨折线通常位于冠状面。该结果可以为手术入路及内固定选择提供参考。
Objective To explore the incidence and morphology of the posterolateral fracture fragment affecting the fibular notch in posterior pilon fracture.Methods A retrospective analysis was conducted of the CT and clinical data of the 31 patients with posterior pilon fracture who had been treated at Department of Orthopaedic,China-Japan Friendship Hospital from May 2013 to May 2018.They were 17 men and 14 women,aged from 20 to 68 years(average,42 years).The injury affected the left side in 13 cases and the right side in 18 ones.The incidence of the posterolateral fracture fragments affecting the fibular notch was counted.The morphologic indexes of the fragments were measured like axial angle of their fracture line,fragment area,fragment height,and sagittal angle of their fracture line.Results A posterolateral fracture fragment affecting the fibular notch was found in all the 31 posterior pilon fractures,giving an incidence of 100%in the posterior pilon fracture.The fracture line of the fragments tended to be in the coronal plane.The axial angle of the fracture line was 20.25°±9.48°;the ratio of the fragment area to the distal tibial articular area was 15.78%±6.75%;the fragment height was 36.59 mm±10.70 mm;the sagittal angle of the fracture line was 18.37°±5.45°.Conclusions A posterolateral fracture fragment affecting the fibular notch can be found in all the posterior pilon fractures.It does not affect a large articular area and its fracture line is usually located in the coronal plane.These data may help choose appropriate surgical approach and internal fixation.
作者
杨雨润
陈瀛
林朋
刘成刚
王立强
朱前拯
杨欢
陈星佐
徐小东
Yang Yurun;Chen Ying;Lin Peng;Liu Chenggang;Wang Liqiang;Zhu Qianzheng;Yang Huan;Chen Xingzuo;Xu Xiaodong(Department of Orthopaedic,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2020年第7期628-631,共4页
Chinese Journal of Orthopaedic Trauma
基金
中日友好医院院级科研基金(2018-2-QN-37)。
关键词
踝关节
骨折
下胫腓联合
Ankle joint
Fractures
bone
Distal tibiofibular syndesmosis
