摘要
目的分析HawkinsⅢ型距骨颈骨折脱位及距骨完全脱位(TDT)的影像学特点及鉴别要点。方法搜集9例HawkinsⅢ型距骨颈骨折脱位、7例TDT患者的临床及影像学资料。9例HawkinsⅢ型距骨颈骨折脱位中8例男性、1例女性,年龄20~53岁,中位年龄29岁;7例TDT均为男性,年龄21~61岁,中位年龄43岁,对比分析HawkinsⅢ型距骨颈骨折脱位及TDT影像学特点及征象。结果9例HawkinsⅢ型距骨颈骨折脱位CT冠状面(踝关节正位片)显示距骨内移6例、外移3例,CT矢状面(踝关节侧位片)显示距骨后移8例,CT横断面显示距骨外展3例。根据距骨移位分为后内侧移位5例,后外侧移位3例,单纯内移1例;根据距骨旋转分为跖屈型2例,跖屈内翻型1例,背屈外展型3例,背屈外翻型2例,外翻型1例;根据伴发踝关节骨折分为伴发内踝骨折5例,伴发外踝骨折2例。7例TDT中冠状面距骨外移7例,矢状面距骨前移7例,横断面距骨外展3例。根据距骨移位均为前外侧移位;根据距骨旋转分为跖屈外翻型1例,跖屈内翻型1例,背屈外翻型1例,内翻内收型1例,外翻型1例,内收型2例;根据伴发踝关节骨折分为伴发距骨后突骨折5例,内踝骨折1例,外踝骨折2例;HawkinsⅢ型距骨颈骨折脱位、TDT CT冠状面重组均显示踝穴空虚,呈“距骨丢失征”,HawkinsⅢ型距骨颈骨折脱位CT矢状面重组显示距骨头、距骨体明显错位、分离,呈"距骨分离征"。结论HawkinsⅢ型距骨颈骨折脱位以后内移位和后外移位多见,TDT以前外侧移位多见。距骨的旋转相对复杂,应从三个维度分析距骨移位及旋转情况,常伴有周围骨质骨折。
Objective To analyze the imaging characteristics and distinguishing points of HawkinsⅢtype talar neck fracture and dislocation and total dislocation of talus.Methods To retrospectively analyze the clinical and imaging data of 9 cases of HawkinsⅢtype talar neck fracture and dislocation(Group 1,8 males,1 female,age range 20-53 y/o,median age 29 y/o)and 7 cases with complete dislocation of the talus(Group 2,7 males,age range 21-61 y/o,median age 43 y/o).Theimaging features of both groups were compared.Results 9 cases of HawkinsⅢtype talus neck fracture and dislocation CT coronal plane(ankle joint anterior view)in 6 cases of talus displacement inward and 3 cases,CT sagittal plane(ankle joint lateral view)in 8 cases of talus posterior displacement,no anteroposterior displacement 1 case,3 cases of talus abduction on CT cross-section;5 cases of posteromedial displacement,3 cases of posterolateral displacement,and 1 case of simple internal displacement according to talar displacement;2 cases of metatarsal flexion type according to talar rotation.1 case of plantar flexion and varus type,3 cases of dorsiflexion abduction type,2 cases of dorsiflexion valgus type,and 1 case of valgus type.According to the associated ankle fractures,they were divided into 5 cases with internal malleolar fractures and 2 with lateral malleolar fractures.7 cases of complete dislocation of the talus,7 cases of coronal displacement of the talus,7 cases of the sagittal plane of the anterior talus,3 cases of the cross-sectional talus abduction,and anterolateral displacement according to the displacement of the talus type 1 case.Plantarflexionvarus type 1 case,dorsiflexion valgus type 1 case,varus adduction type 1 case,valgus type 1 case and adduction type 2 cases.According to concomitant ankle fractures,they were divided into 5 cases of concomitant talus posterior process fractures,1 case of medial malleolus fracture,and 2 cases of lateral malleolus fracture."Loss sign",HawkinsⅢtalar neck fracture and dislocation CT sagittal plane reconstruc
作者
桑辉
刘彬
宋彦芳
王勇
刘莹
张平
张泽坤
SANG Hui;LIU Bin;SONG Yanfang(Department of Radiology,Hebei Province Hospital of Chinese Medicine,Shijiazhuang,Hebei Province 050011,P.R.China)
出处
《临床放射学杂志》
北大核心
2021年第11期2178-2182,共5页
Journal of Clinical Radiology
关键词
距骨
脱位
骨折
胫距关节
距下关节
Talus
Dislocation
Fracture
Talocrural joint
Talonavicular joint
