| Objective:To explore the application value of Three Dimensional CT reconstruction in the diagnosis and treatment of distal radius fractures.To provide scientific theoretical basis for improving the accuracy of diagnosis and postoperative evaluation of distal radius fractures.Methods: According to the inclusion criteria and exclusion criteria,we selected 50 cases of the patients,including cases of 18 male and 32 female,who were received by Department of orthopedics,affiliated Ruikang Hospital of Guangxi traditional Chinese Medicine University from January2016 to January 2017.All the patients were examined with Positive and lateral radiographs of the wrist and three-dimensional CT reconstruction to comparatively analysis the accuracy of X-ray plain film and three-dimensional CT reconstruction in the diagnosis of distal radius fractures.Having Classified Melon fracture,we did open reduction and internal fixation with locking plate for types II to V fracture patients and gave bone grafting for those who were suffered more articular surface collapse defect,after take out stitches the wounds ware external washing with external wash 1.All patients underwent imaging examination according to preoperative imaging method after having been operation to comparatively analysis the sensitivity of efficacy evaluation of X-ray and three-dimensional CT reconstruction in the treatment of distal radius fractures.We then did functional score to the patient’s wrist after 1 months’ time and 3 months’ timeof the operation according to the Cooney wrist score standard,to comparatively analysis the sensitivity of patients’ wrist function assessment of X-ray and three-dimensional CT reconstruction in the treatment of distal radius fractures.Results:According to the standard of Melon classification of distal radius fracture,we listed preoperative X-ray diagnostic classification,including 28 cases of type II;13 cases of type III;6 cases of type IV;3 cases of type V,and also preoperative CT diagnostic classification,including 22 cases of type II;12 cases of type III;9 cases of type IV and 7 cases of type V.Intraoperative diagnosis was the gold standard for diagnosis,recording data of 22 cases type II;10 cases of type III;10 cases of type IV;8 cases of type V.This set of data shows that the X-ray and three-dimensional CT reconstruction was statistically significant not only in the Diagnostic positive rate difference in the Diagnosis of distal radius fracture but also in the contrast difference of each type.As for the comparison of the results of postoperative fracture reduction,50 cases’ X-ray plain film results showed that anatomical reduction accounted for 31 cases and non-anatomical reduction accounted for 19cases;the results of three dimensional CT reconstruction showed that 42 cases were anatomical reduction,and the others was non anatomic reduction,accounting for 8 cases.Both were statistically significant in evaluating the difference of the Fracture reduction effect showed that the location of the internal fixation was good in 34 cases,the internal fixation of the poor position accounted for 16 cases.In the Internal fixed position evaluation after operation,50 cases of patients’ X-ray plain film results showed good position of internal fixation accounted for 34 cases,and poor position of internal fixation accounted for 16 cases;the results of three dimensional CT reconstruction showed that good position of internal fixation accounted for 43 cases,and poor position of internal fixation accounted for 7cases.Both were statistically significant in evaluating the difference of internal fixed position effect.According to the Cooney wrist score standard,1 months after operation,the score of joint function which were poor accounted for 10 cases,the score of joint function which were just fair accounted for 40 cases,while good or excellent score of joint function both accounted for 0cases.3 months after operation,the score of joint function which were poor accounted for 1case,the score of joint function which were just fair accounted for 8 cases.The score of joint function which were good accounted for18 case,and the score of joint function which were excellent accounted for 23 cases.1 months after operation,the score of joint function for 40 patients according to the anatomic display of X-ray and CT and non anatomical reduction statistics,X-ray showed anatomical reduction in 28 cases,12 cases of non anatomic reduction,CT showed 36 cases with anatomic reduction,non anatomic reduction in 4 cases,compared the difference was statistically significant;there was no significant difference between the 10 patients in the joint function score of the patients at the end of the 1 months.After 3 months of the operation,the joint function score was excellent in the treatment of 41 cases,X-ray showed anatomical reduction in 29 cases,non anatomical reduction in 12 cases,CT showed anatomical reduction in 37 cases,non anatomical reduction in 4 cases,the difference between the two groups were statistically significant;there were no significant differences between the 9patients in the joint function score of the patients in the 3 months after operation.Conclusions:Compared with X plain film examination,three dimensional CT reconstruction has a higher application value in the diagnosis of distal radius fractures,in the effect of postoperative reduction and theevaluation of internal fixation about patients with distal radius fracture,three dimensional CT reconstruction has the obvious superiority compared with the X-ray plain film,and is more advantageous for the clinician to discover questions earlier and make intervention to maximize the benefits of treatment for the patients.Of the relationship between wrist joint function and imaging evaluation of postoperative distal radius fractures.Three dimensional CT reconstruction is more sensitive to the wrist joint function than X-ray plain film,and can more accurately evaluate the function of wrist joint.Three dimensional CT reconstruction has a pretty high Clinical application value in the diagnosis and treatment of distal radius fractures,so it is well worth popularing and applying on clinic. |
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