MSCT三维重技术对肱骨近端骨折分型及治疗的指导意义.pdfVIP

THE INDISPENSABLE SIGNIFICANCE OF MSCT 3-D RECONSTRUCTION TECHNIQUES IN GUIDING THE TREATMENT AND TYPING OF PROXIMAL HUMERUS FRACTURES Specialty: Orthopaedics of TCM Author: Sun Jie Tutor: Bi Rongxiu Abstract OBJECTIVE : TO INVESTIGATE THE APPLICATION OF THE MULTI-SLICE CT(MULTI-SLICE SPIRAL COMPUTED TOMOGRAPHY, MSCT)RECONSTRUCTION TECHNIQUES IN DIAGNOSING PROXIMAL HUMERUS FRACTURES, EVALUATE THE VALUE IN GUIDING THE TREATMENT OF THE PROXIMAL HUMERUS FRACTURES. METHODS : (1) 20 CASES OF PROXIMAL HUMERUS FRACTURES WERE EXAMINED WITH ROUTINE X-RAY WAY, INCLUDING ANTEROPOSTERIOR POSITION AND LATERAL POSITION THROUGH CHEST. FURTHERMORE, THOSE WERE ALSO SCANNED WITH MSCT, INCLUDING THE PROXIMAL HUMERUS AND THEN RECONSTRUCTED THREE-DIMENSIONAL IMAGES. (2) THESE 20 CASES WERE CLASSIFIED WITH THE STANDARDS OF NEER ’S CLASSIFICATION, ACCORDING TO X-RAY PLAIN FILM, TWO-DIMENSIONAL CT FILM AND THREE-DIMENSIONAL RECONSTRUCTION FILM. THE WORK WAS DONE TWICE BY FIVE ORTHOPEDISTS RESPECTIVELY, WITH AN INTERVAL OF THREE MONTHS. RESULTS : (1) THREE-DIMENSIONAL RECONSTRUCTION OF PROXIMAL HUMERUS COULD SHOW SPATIAL RELATION OF FRACTURES CLEARLY, WHICH HOLDS MORE INFORMATION THAN ROUTINE X-RAY. FRACTURED FRAGMENTS OF 12 CASES WERE ONLY FOUND BY THE FORMER. 2 THERE IS STATISTICAL DIFFERENCE IN SUCH CLASSIFICATION USING X-RAY(P0.05) AND TWO-DIMENSIONAL CT (P0.05) RESPECTIVELY CLASSIFICATION WITH AN INTERVAL OF THREE MONTHS ACCORDING TO NEER ’S CLASSIFICATION, HOWEVER, NO STATISTICAL DIFFERENCE IS FOUND USING THREE-DIMENSIONAL RECONSTRUCTION(P0.05). CONCLUSION: ALTHOUGH X-RAY PLAIN FILM IS THE FI