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目的通过 CT 测量跟骨关节内移位骨折的关节外变化指标,评价 CT 对该类损伤的诊断价值。方法对40个成人跟骨标本、20个正常健康成人及20个跟骨关节内骨折足的 CT 图像进行测量获得跟骨高度、跟骨宽度、距跟角及跟骰角,对以上获得值进行 t 检验或单向方差分析。结果(1)跟骨高度的测量:正常成人跟骨标本后关节面最高点处高度为(43.07±2.85)mm,跟骨结节最高点处高度为(44.69±3.67)mm;正常成人健康足 CT 冠状面图像的结果分别为(42.84±1.66)mm、(43.40±3.01)mm,对以上两组数据进行比较,相互之间差异无统计学意义(P>0.001)。骨折足 CT冠状面图像的结果分别为(34.76±3.24)mm、(40.41±3.69)mm,与前两组数据之间比较,差异有统计学意义(P 值均<0.001。(2)跟骨宽度测量:正常成人跟骨标本载距突后缘处跟骨宽度为(30.53±2.06)mm,跟骨结节最宽处的宽度为(33.57±2.17)mm;正常成人健康足 CT 冠状面图像的测量结果分别为(30.47±2.33)mm、(32.69±2.00)mm,对以上两组数据进行比较,相互之间差异无统计学意义(P>0.001)。骨折足 CT 冠状面图像的结果分别为(45.99±4.79)mm、(36.28±2.08)mm,与前两组数据之间比较,差异均有统计学意义(P 值均<0.001)。(3)跟骨内翻角测量:正常成人健康足 CT 轴面图像的跟骰角为25.56°±0.95°,冠状面图像测得的距跟角为13.33°±0.75°;而对发生跟骨骨折的足进行 CT 扫描,其测得的结果分别为30.15°±1.62°、22.51°±1.34°。两组相对应的数据之间进行比较,差异均有统计学意义(P 值均<0.001)。结论 CT 检查是评价跟骨关节内移位骨折病例的关节外变化的有效手段。
Objective To measure the extra-articular changes of intra-articular calcaneal displaced fractures by CT and evaluate the diagnostic value of CT in this kind of injury. Methods CT images of 40 adult calcaneal specimens, 20 normal healthy adults and 20 calcaneal fractures of the calcaneus were measured to obtain calcaneal height, calcaneus width, heel angle and heel angle. The obtained values were obtained t test or one-way analysis of variance. Results (1) Measurement of calcaneus height: The height of the highest articular surface of adult adult calcaneus specimens was (43.07 ± 2.85) mm and the height of calcaneal nodules was (44.69 ± 3.67) mm; The results of CT coronal images were (42.84 ± 1.66) mm and (43.40 ± 3.01) mm respectively. There was no significant difference between the two groups (P> 0.001). The results of coronal images of fracture CT were (34.76 ± 3.24) mm and (40.41 ± 3.69) mm, respectively, which were significantly different from those of the previous two groups (all P <0.001. (2) Measurement of width: The width of calcaneus at the posterior margin of normal adult calcaneus was (30.53 ± 2.06) mm and the width of calcaneal nodule was (33.57 ± 2.17) mm. The coronal image of normal adult healthy foot CT (30.47 ± 2.33) mm and (32.69 ± 2.00) mm, respectively, and there was no significant difference between the two groups (P> 0.001) .The results of CT coronal images of fractures (45.99 ± 4.79) mm and (36.28 ± 2.08) mm, respectively. The differences between the two groups were statistically significant (P <0.001). (3) The heel angle of healthy foot CT images was 25.56 ° ± 0.95 °, and the heel angle measured by coronal images was 13.33 ° ± 0.75 °. CT scan of the foot with calcaneal fractures was performed. The measured results Respectively, 30.15 ° ± 1.62 ° and 22.51 ° ± 1.34 °, respectively.Comparing the data of the two groups, the differences were statistically significant (P <0.001) .Conclusion CT examination is a Effective means of change outside of joint fractures were displaced intraarticular calcaneal.