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螺旋CT检查对诊断踝足部隐匿性骨折的价值

[Value of spiral CT examination for diagnosis of occult fracture of ankle and foot].

作者信息

Lü Dong-liang, Jin Jing, Gu Shi-jun, Zhu Ying, Xu Bin, Shao Hua, Han Qi

机构信息

Department of Radiology, the Third People's Hospital of Cixi, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2011 Jun;24(6):522-6.

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.

摘要

目的

探讨螺旋CT检查对X线检查阴性但高度怀疑骨折患者隐匿性骨折的诊断价值,以减少误诊。

方法

选取2007年1月至2010年6月间31例踝关节外伤患者行螺旋CT检查,其中男18例,女13例,年龄21~67岁,平均35岁。患者主要症状为踝关节疼痛、局部肿胀、压痛明显及活动受限。所有患者X线检查均为阴性。

结果

螺旋CT检查发现骨折11例,共17处。单处骨折6例,其中外踝骨折1例,距骨骨折1例,舟骨骨折1例,第5跖骨基底骨折1例,跟骨骨折2例。多处骨折5例,其中内、外踝骨折1例;内踝、跟骨及距骨骨折1例;距骨及舟骨骨折1例;第1、2楔骨骨折1例;第2、3跖骨基底骨折1例。

结论

对于X线检查阴性但高度怀疑骨折的患者,需行螺旋CT检查,可显著提高隐匿性骨折的检出率,为临床治疗及司法鉴定提供影像学依据。

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