Helical CT three-dimensional and multiplanar reconstruction for evaluation of acetabular fractures / 中华骨科杂志

ABSTRACT

Objective To explore the clinical value of helical CT surface shaded display (SSD) and multiplanar reconstruction (MPR) images in diagnosing the acetabular fractures. Methods According to the anatomical basis of "Y" type cartilage in children acetabulum, adult acetabulum was divided into "two columns" the anterior and posterior column and "four walls"the anterior, posterior, medial and roof walls, so as to define the localization, type, interface and union of fractures accurately. Results From 1999 to 2001, 68 cases of acetabluar fractures were reviewed. Of 68 cases, 28 cases were diagnosed as complex double columns and three walls (anterior, posterior and interior wall respectively) fracture, 7 cases as complex single column (anterior column) and three walls (anterior, posterior and interior wall) fracture, 5 as complex single column (anterior column) and two walls (anterior and interior wall) fracture, 21 as simple posterior wall fracture, 7 as simple anterior wall. In this group, 21 complex double columns and three walls fractures, 7 complex single column and three walls fractures, 5 complex single column and two walls fractures, 15 simple posterior wall fractures, 3 simple anterior wall fractures had reduction and internal fixed with plates or absorbable screws; another 7 complex double columns and three walls fractures, 6 simple posterior wall fractures, 4 simple anterior wall fractures were treated with traction reduction because the separation and displacement of their fragments were not significant. Using ?2 statistical analysis,there was a significant difference between the X-ray film and SSD and MPR in demonstrating the numbers and types. Conclusion SSD and MPR reconstruction imagines are of instructive importance in sufficient evaluation, operative preparation and appropriate instrumentation of internal fixation. In the management of acbtabular fracture, plates are needed to stabilize the fracture involved the anterior or posterior column, while the fragments of anterior or posterior wall are only fixed with screws, small fragments could be removed in order to avoid forming loose body. Therefore, SSD and MPR are the regular and important method in preoperative examination of complex acetabular fracture and dislocation.