多层螺旋CT足踝部隐匿性骨折的诊断价值
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作者Author单位AddressE-Mail
吕冬亮 LV Dong-liang 慈溪市第三人民医院放射科,浙江 慈溪 315324 Department of Radiology,the Third People's Hospital of Cixi,Cixi 315324,Zhejiang,China ldl9507@163.com 
金晶 JIN Jing 慈溪市第三人民医院放射科,浙江 慈溪 315324 Department of Radiology,the Third People's Hospital of Cixi,Cixi 315324,Zhejiang,China  
谷水君 GU Shui-jun 慈溪市第三人民医院放射科,浙江 慈溪 315324 Department of Radiology,the Third People's Hospital of Cixi,Cixi 315324,Zhejiang,China  
祝莹 ZHU Ying 慈溪市第三人民医院放射科,浙江 慈溪 315324 Department of Radiology,the Third People's Hospital of Cixi,Cixi 315324,Zhejiang,China  
徐斌 XU Bin 慈溪市第三人民医院放射科,浙江 慈溪 315324 Department of Radiology,the Third People's Hospital of Cixi,Cixi 315324,Zhejiang,China  
邵华 SHAO Hua 慈溪市第三人民医院放射科,浙江 慈溪 315324 Department of Radiology,the Third People's Hospital of Cixi,Cixi 315324,Zhejiang,China  
韩琦 HAN Qi 慈溪市第三人民医院放射科,浙江 慈溪 315324 Department of Radiology,the Third People's Hospital of Cixi,Cixi 315324,Zhejiang,China  
期刊信息:《中国骨伤》2011年,第24卷,第6期,第522-526页
DOI:10.3969/j.issn.1003-0034.2011.06.025
基金项目:
中文摘要:

目的:通过对隐匿性骨折的诊断,提示足踝部外伤后X线检查阴性、临床高度怀疑有骨折的患者进行多层螺旋CT检查的必要性,以期减少漏诊、误诊。

方法:收集2007年1月至2010年6月31例足踝部外伤病例,男18例,女13例;年龄21~67岁,平均35岁。均有明确外伤史,主要表现为足踝部疼痛,局部肿胀,压痛点固定,压痛明显,活动受限。31例X线检查均阴性,因临床高度怀疑骨折而行多层螺旋CT检查。

结果:螺旋CT检查发现11例骨折,共累及17处。单发骨折6例,多发骨折5例。单发骨折中,外踝骨折1例,距骨骨折1例,足舟骨骨折1例,第5跖骨基底部骨折1例,跟骨骨折2例;多发骨折中,内、外踝骨折1例,内踝、跟骨、距骨骨折1例,距骨、足舟骨骨折1例,足第1、2楔骨骨折1例,第2、3跖骨基底部骨折1例。

结论:足踝部外伤后X线片检查阴性、临床高度怀疑有骨折的患者进行多层螺旋CT检查,可明显提高隐匿性骨折的检出率,为临床治疗及司法鉴定提供可靠的影像学依据,具有重要的应用价值。
【关键词】体层摄影术,螺旋计算机    踝关节  骨折  诊断
 
Value of spiral CT examination for diagnosis of occult fracture of ankle and foot
ABSTRACT  

Objective: To investigate the value of spiral CT examination for diagnosis occult fracture of the patients with negative result of X-ray examination and with high suspicion of fractures,so as to reduce misdiagnosis.

Methods: From January 2007 to June 2010,31 patients with ankle trauma performed spiral CT examination,including 18 males and 13 females,ranging in age from 21 to 67 years,with a mean of 35 years. The main symptoms of the patients included ankle pain,local swelling,obvious tenderness and activity limitation. All the patients had negative results of X-ray examination.

Results: The spiral CT examination revealed 11 patients with fractures,involving a total of 17 points. Single fracture were found in 6 cases,and multiple fractures were found in 5 cases. Among single fractures,the lateral malleolus fracture was found in 1 case,talus fracture was found in 1 case,scaphoid fracture was found in 1 case,the fracture of the base of 5th metatarsal base was found in 1 case and calcaneal fractures were found in 2 cases. Within multiple fractures,internal and lateral malleolus fracture were found in 1 case;medial malleolus,calcaneus and talus fractures were found in 1 case; talus and scaphoid fractures were found in 1 case;the fractures of 1st and 2nd cuneiform bone were found in 1 case;the 2nd and 3rd metatarsal base fracture was found in 1 case.

Conclusion: For the patients with negative X-ray examination and high suspicion of fractures,the spiral CT examination is needed,which could significantly improve the detection rate of occult fractures,and provide imaging basis for clinical treatment and judicial identify.
KEY WORDS  Tomography,spiral computed  Foot  Ankle joint  Fractures  Diagnosis
 
引用本文,请按以下格式著录参考文献:
中文格式:吕冬亮,金晶,谷水君,祝莹,徐斌,邵华,韩琦.多层螺旋CT足踝部隐匿性骨折的诊断价值[J].中国骨伤,2011,24(6):522~526
英文格式:LV Dong-liang,JIN Jing,GU Shui-jun,ZHU Ying,XU Bin,SHAO Hua,HAN Qi.Value of spiral CT examination for diagnosis of occult fracture of ankle and foot[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(6):522~526
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