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目的用CT测量肘关节“恐怖三联征”中尺骨冠状突骨折高度并探讨其分型。方法纳入自2013-05—2016-08诊治的肘关节“恐怖三联征”26例,尺骨冠状突骨折按Regan-Morrey分型:Ⅰ型7例,Ⅱ型18例,Ⅲ型1例。采用容积再现法(VR)和多平面重建法(MPR)行三维和二维CT重建,在重建图像上用软件测量尺骨冠状突骨折高度。结果本组尺骨冠状突尖部横形骨折23例,前内侧面骨折2例,基底部骨折1例。尺骨冠状突骨折块高度平均6.4(2.8~11.9)mm,尺骨冠状突总高度平均17.8(14.6~21.1)mm;尺骨冠状突骨折块高度占尺骨冠状突总高度的比值平均36%(16%~67%)。尺骨冠状突骨折块高度占尺骨冠状突总高度的比值<20%者2例,20%~29%者5例,30%~39%者9例,40%~50%者9例,仅1例比值>50%。结论采用CT三维及二维重建技术可观察尺骨冠状突骨折位置、骨折块形态及大小,测量骨折块高度并进行分型,为制定手术方案提供客观依据。
Objective To measure the height of coronoid fractures in the elbow joint and terrible triad levy by CT, and discuss its classification. Methods Twenty-six elbow cases were screened from 2013-05-2016-08. According to Regan-Morrey classification, there were 7 cases of type Ⅰ, 18 cases of type Ⅱ and 1 case of type Ⅲ. Volume reconstruction (VR) and multiplanar reconstruction (MPR) were used to reconstruct the three-dimensional and two-dimensional CT images. Software was used to measure the fracture height of the coronoid process in reconstructed images. Results The group had 23 cases of horizontal fractures of coronoid process in the ulnar, 2 cases of anteromedial fracture and 1 case of basement fracture. The height of ulna coronoid fractures was 6.4% (2.8-11.9) mm in average and 17.8 (14.6-21.1) mm in average. The ratio of coronoid fractures to the total height of ulna coronoid was 36% (16% ~ 67%). The ratio of the height of the ulna coronoid fracture to the total height of the coronoid process was less than 20% in 2 cases, 20% -29% in 5 cases, 30% -39% in 9 cases, 40% -50% in 9 cases and only 1 Example ratio> 50%. Conclusions The 3D coronal and 2D reconstruction techniques can be used to observe the location of coronoid fractures, the shape and size of the fractures, the height of the fractures and the classification of coronoid fractures. This provides an objective basis for the development of surgical plans.