摘要
背景:按照三柱理论,有桡骨远端单柱和双柱die-punch骨折之分,文献已有单柱die-punch骨折分型报道,但尚无双柱die-punch骨折类型报道。目的:探讨桡骨远端双柱die-punch骨折影像学特点和类型,以及新分型的价值。方法:回顾性分析2007年6月至2017年6月498例桡骨远端双柱die-punch骨折影像学资料,根据影像学特点分为干骺端型、关节面型和混合型3型。选择2名影像学医师独立对100例桡骨远端双柱die-punch骨折行分型,分型结果采用Kappa方法行一致性分析。结果与结论:(1)498例桡骨远端双柱die-punch骨折患者中,干骺端型130例,关节面型156例,混合型212例,未见无法归类者;(2)观察者间的Kappa系数为0.823-0.868,观察者内的Kappa系数为0.868-0.900,具有高度一致性;(3)按AO骨折分型,关节面型属于B型或C型,干骺端型和混合型均属于C型;(4)据此得出,该桡骨远端双柱die-punch骨折影像学分型较好地反映了骨折发生力学机制和骨折部位等特点,符合AO骨折分型原则,一致性好,对临床治疗和预后判断具有一定参考价值。
BACKGROUND: According to the three-column theory, there are single-column and double-column die-punchfractures of the distal radius. The single-column die-punch fracture has been reported, but there is a lack ofstudy on double-column die-punch fracture. OBJECTIVE: To explore the characteristics and imaging types of double-column die-punch fracture of the distal radius as well as the value of the new classification. METHODS: A retrospective analysis of imaging data was made in 498 cases of double-column die-punch fracture of the distal radius between June 2007 and June 2017. According to the imaging characteristics of the fracture, the patients were divided into types of metaphysis, articular surface and mixed. Two radiologists were chosen and independently typed the fractures in 100 cases of double-column die-punch fracture of the distal radius, and agreement was analyzed with Kappa statistics. RESULTS AND CONCLUSION: (1) In 498 cases of double-column die-punch fracture of the distal radius, type of metaphysis was found in 130 cases, type of articular surface in 156 cases and mixed type in 212 cases, and all were categorized. (2) The inter-observer Kappa coefficient was 0.823-0.868 and the intra-observer Kappa coefficient was 0.868-0.900, showing high consistency. (3) According to AO classification of fracture, the type of articular surface belonged to type B or type C, type of metaphysis and the mixed type belonged to type C. (4) These results suggest that the new imaging typing of double-column die-punch fracture of the distal radius well reflects the mechanical characteristics and fracture site, meets the principle of AO classification, has high consistency and provides reference for clinical treatment and prognosis judgment.
作者
奚彬
杨莹
李冬成
丁燕萍
殷渠东
Xi Bin;Yang Ying;Li Dong-cheng;Ding Yan-ping;Yin Qu-dong(Department of Radiology;Department of Orthopedics,Wuxi No.9 People’s Hospital,Wuxi 214062,Jiangsu Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2018年第27期4405-4409,共5页
Chinese Journal of Tissue Engineering Research