| 董方,解耀锃,周恩昌,等.术前 MSCT对胫骨平台骨折伴半月板损伤的诊断价值[J].安徽医药,2025,29(1):91-95. |
| 术前 MSCT对胫骨平台骨折伴半月板损伤的诊断价值 |
| Diagnostic value of MSCT in tibial plateau fracture with meniscus injury before operation |
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| DOI：10.3969/j.issn.1009-6469.2025.01.018 |
| 中文关键词: 胫骨半月板损伤 多层螺旋计算机断层扫描 胫骨平台骨折 半月板损伤 Schatzker分型 诊断 |
| 英文关键词: Tibial meniscus injuries Multilayer spiral computed tomography Fracture of the tibial plateau Meniscus injury Schatzker classification Diagnosis |
| 基金项目:山东省医药卫生科技发展计划项目( 2019WS106) |
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| 中文摘要: |
| 目的探讨术前多层螺旋计算机断层扫描( MSCT)对胫骨平台骨折伴半月板损伤的诊断价值。方法回顾 2017年 1月至 2022年 12月聊城市第二人民医院收治的 83例行胫骨平台骨折内固定术治疗病人的临床资料，术前均接受 MSCT检查，以术中骨折复位内固定后即刻关节镜下所见有无发生半月板损伤为金标准分为半月板损伤组和无半月板损伤组。比较两组病人基线资料及 MSCT参数，绘制受试者操作特征曲线(ROC曲线)分析 MSCT参数对复杂胫骨平台骨折伴半月板损伤的诊断价值。结果 83例胫骨平台骨折病人发生半月板损伤共 39例( 46.99%)Ⅳ型半月板损伤发生率为 18.75%(3/16)，低于 Ⅱ型的 59.52%(25/42)(P<0.05)。半月板损伤组中 Schatzker Ⅱ型占比高于无半，月板损伤组， Schatzker Ⅳ型占比及术前 MSCT检测骨折切线至塌陷最低点距离、外侧髁切线至骨折块远端距离、塌陷相对面积高于低于无半月板损伤组( P<0.05)。 ROC曲线分析显示，骨折切线至塌陷最低点距离、外侧髁切线至骨折块远端距离、塌陷相对面积单独及联合应用诊断胫骨平台骨折伴半月板损伤的 ROC曲线下面积( AUC)(95%CI)为 0.64(0.56，0.72)、 0.70(0.62，0.78)、 0.76(0.67，0.83)、 0.89(0.83，0.94)，联合应用的诊断价值高于单独应用( P<0.05)。结论术前 MSCT测量胫骨平台骨折外侧髁切线至骨折块远端距离、塌陷相对面积等参数对半月板损伤的诊断有重要参考价值。 |
| 英文摘要: |
| Objective To evaluate the diagnostic value of preoperative multi-slice computed tomography (MSCT) in tibial plateau fracture with meniscus injury.Methods The clinical data of 83 patients admitted to Liaocheng Second People's Hospital from January2017 to December 2022 who were proposed to be treated with internal fixation of tibial plateau fractures were reviewed. All patients un-derwent preoperative MSCT and were divided into meniscus injury group and no meniscus injury group based on the gold standard ofwhether meniscal injury occurred as seen arthroscopically immediately after intraoperative fracture reduction and internal fixation.Baseline data and MSCT parameters were compared between the two groups. Subject work characteristic curve (ROC curve) was plottedto analyse the diagnostic value of MSCT parameters in complex tibial plateau fracture with meniscus injury.Results Meniscus injuryoccurred in 39 (46.99%) cases of 83 patients with tibial plateau fractures, and the incidence of meniscus injury in type Ⅳ was 18.75%(3/16), which was lower than that in type Ⅱ (59.52% (25/42) (P<0.05). The percentage of Schatzker type Ⅱ was higher in the meniscusinjury group than that in the no meniscus injury group, and the percentage of Schatzker type Ⅳ, the distance from the fracture tangentline to the lowest point of collapse, the distance from the lateral condyle tangent line to the distal end of the fracture block, and the rela-tive area of collapse detected by preoperative MSCT were higher than those in the no meniscus injury group (P<0.05). ROC curve analy-sis showed that the area under ROC curve (AUC) (95% CI) for fracture tangent line to nadir of collapse distance, lateral condyle tangentline to distal fracture block distance, and relative area of collapse alone and in combination for diagnosing meniscal injury of tibial pla-teau fractures was 0.64 (0.56,0.72), 0.70 (0.62,0.78), 0.76 (0.67,0.83), and 0.89 (0.83,0.94), with the diagnostic value of the combinedapplication being higher than that single application (P<0.05). Conclusion Preoperative MSCT measurements of the lateral condyletangential line to the distal end of the fracture block and the relative area of collapse are valuable for the diagnosis of meniscus injury. |
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