Spiral computerized tomographic SSD and MPR imaging of complex shoulder fractures / 中华骨科杂志

ABSTRACT

Objective To investigate the clinical value of spiral computerized tomographic shaded surface display (SSD) and multiplanar(MPR) imaging of complex shoulder fractures. Methods Twenty four cases of complex shoulder fractures including 16 cases with displaced proximal humeral fractures and 8 cases with displaced fractures of glenoid fossa were examined preoperatively with X ray, 15 cases of them were examined with SSD and MPR. On the basis of X ray or SSD and MPR of SCT all fractures were classified with Neer and modified Ideberg system; the true rate of fracture classification by use of two methods was compared with each other. Results Evidenced by intraperative observation, 10 of 16 displaced proximal humeral fractures cases were Neer three part fractures, 6 were four part fractures cases. Among the 8 cases of glenoid fossa fractures, there were 2 cases of type Ⅲ, 3 cases of type Ⅳ and 3 cases of type Ⅴ. The true rate of SSD and MPR of SCT is 93.3%(14/15) while X rays is 41.7%(10/24); there was significant difference between two methods (Fishers exact test, P=0.02). All SSD and MPR of SCT play an important role in the treatment of complex shoulder fractures. Conclusion SSD and MPR of SCT is able to clearly display complex shoulder fractures three dimensionally. It is helpful to correctly classify the fractures, select appropriate surgical approach, prepare surgical instruments and understand the complexity of the fractures.