The Clinical Research Of Navicular Fracture And Related Measurement Of X-ray

Objective:Compared to other parts of the fracture, navicular fracturedoes not be seen more, because the midfoot is formed with dorsal and plantarligament network firmly. But the fracture types is more complicated, damagedegree also varied, from simple ligament avulsed fracture to complicatedfracture dislocation. And according to each type of fracture,treatment alsovaried, this undoubtedly increase the actual difficulty of treatment, in clinicalwork it is challenging. The key to treatment is knowing exactly what fracturebelongs to the subtypes and severe degree, to the corresponding treatment. So,navicular fracture patients should take all-sides of positive, oblique and sideX-ray film.if necessary,CT should be considered in order to have acomprehensive understanding of fracture, distinguishing the specific type andseverity of fracture. And navicular bone is located in the medial longitudinalarch of foot, and plays a "keystone" role in biomechanical structure, in thestructure stability of foot,mechanical transmission and movement gaitregulation. Navicular fracture includes avulsed fracture, navicular nodulesfracture, fracture of body, stress fracture.The fracture of body is relativelycomplicated, and can occur in many positions and the direction of the fractureline can be varied. Usually axial extrusion or compression caused byhigh-energy violence, separation of fracture block is often more apparent,bone-loss serious, according to fracture type is different, the first and secondphalanges will lose their support and become varus or valgus. In a full look on,the bow weight axis formed with the first and second metatarsal bone, the firstcuneiform bone and navicular bone will change, and then Angle of foot insidelongitudinal arch mechanical transmission and distribution change, and crossbow of foot will also be affected thereby. Therefore,when meet navicular fracture patients,we should distinguish the subtypes, judge whether the mediallongitudinal arch of foot change and the degree of change, in order to guidetherapy. We statistically analyzed138cases of navicular bone fracture cases inthe recent three years, try to taking them into subtype. Mearsure the positiveX-ray film of obvious separated body fracture cases with some indicators, inorder to evaluate the influence of forefoot and medial arch of foot, in order toguide clinic therapy.Methods:We count138cases of navicular fracture cured in the thirdhospital of hebei medical university in the nearly three years, obtaining their X-ray film material.With the help of radiologists we separated them intosubtype and statistical number, sex ratio, age distribution and injury factors.Fracture is divided into avulsed fracture, navicular nodules fracture, fractureof body and stress fracture. The fracture of body is divided into three typesaccording to the Sangeorzan classification. According to the related literaturematerial,we select two ankle tip connect with the long shaft of first metatarsalbone into first ankle metatarsus angle, two ankle tip connect with the longshaft of second metatarsal bone into second ankle metatarsus angle, long shaftof astragalus and the long shaft of first metatarsal bone into the first astragalusmetatarsus angle, long shaft of astragalus and the long shaft of first metatarsalbone into the first astragalus metatarsus angle and so on four measurement, thebody of fracture cases foot is a X-ray film measurement, record the relevantdata. The other normal adults select the foot is a X ray film fifty cases, thesame to the above four sets of data measured, as the control group, and havethe statistical analysis.Result:Statistics of138cases of navicular bone fracture cases, avulsedfracture47cases (male27cases, female twenty cases), scaphoid nodulesfracture37cases (male21cases, female16cases), the body of fracture54cases, whichⅠtype15cases (male8cases and female7cases), Ⅱtype21cases (male14cases and female7cases), Ⅲ type and cases (male13casesand female5cases), stress fracture do not be counted. The statistical cases areunilateral damage, not statistics double side damage.The left scaphoid fracture in77cases,61cases on the right, the left and the right ratio of1.26. From theage from11to73years old, the average age is33. Compare the first group ofdata with control group to do statistical analysis, P have no meaning. Thesecond, the third data and control group to do statistical analysis, P is less than0.05, there is statistical significance.And the average of the second is less thancontrol group, and the average of the third group is more than control group.Conclusion: We count138cases of navicular fracture cured in the thirdhospital of hebei medical university in the nearly three years,sex ratio, sidestatistics, age distribution, etc. Navicular bone fracture ofⅠtype forefoot haveno obvious separation, the medial longitudinal arch of foot and cross bow offoot is not be effected too much. The forefoot move inside inⅡtype fracture,forefoot move to the lateral in Ⅰ type fracture, affects the longitudinal archand cross bow of foot. Faced with navicular fracture,we should not just simplypay most attention to fracture itself, consideration should also be given to theinfluence of the forefoot, causes the change of arch, the operation should beconsidered through the flock bone, and other means to recover the height ofnavicular bone and cuneiform bone, correct valgus deformity of the first andsecond metatarsal, restore medial longitudinal bow, improve the foot crossbow slump degree, reshape the biomechanical structure of foot, avoid painess,deformity, dysfunction sequela occurrence, in the clinical should be takenseriously. And judgment in the forefoot, ectropion whether you will need thecorrect operation of the X line Angle measurement of the specific quantitativestandard, because need more medical records and long-term follow-up results,this paper did not put forward. Inside and valgus Angle of the forefoot andinternal parapodum bow and cross bow of foot. Relationship of quantitativeangle changing is remained to be pointed out, in order to guide clinical work.