Clinical Application Of The320-slice CT Three-dimensional Reconstruction Classification Of The Intertrochanteric Fracture

PurposeThis study aims to Formulating a new classification of intertrochanteric fractures by320-slice CT three-dimensional reconstruction film, through Contrasting X-ray andintraoperative found and320-slice CT three-dimensional reconstruction ofintertrochanteric fracture, used to guide clinical treatment.Methods and Material100cases of intertrochanteric fractures were Selected, From November2011toFebruary2013, including30males and70females; aged70to95years, mean78.6years.All patients took by320CT three-dimensional reconstruction and X-ray examination;contrasting the number of fracture fragments, stability of the fracture and cortical bonecontinuity, we Formulating a new classification of intertrochanteric fractures according320-slice CT three-dimensional reconstruction typing. All the data was dealt withstatistical software SPSS.ResultsAccording to the three-dimensional reconstruction of the320-slice CT images,intertrochanteric fractures Formulating with stable (stable fracture, classification of S) andunstable (unstable fracture, classification of U). Stable fractures are furture divided intotwo subclassifications. one is S1:3D reconstruction shows along the line ofintertrochanteric fracture, front and rear tuberosity crest complete type,equivalent toEvansIa classification or AO classification A1-1, A1-2; other is S2:along the line ofintertrochanteric fractures and lesser tuberosity fracture, less tuberosity above femoralcortex complete, equivalent to EvansⅠb.Unstable fracture (U) is divided into foursubclassifications. U1classification: fracture line is same direction with intertrochanteric,rear intertrochanteric crest the huge fracture fragments fracture, X-ray equivalent ofEvansIb or EvansIc. U2classification:fracture line is same direction with intertrochanteric,combined size intertrochanteric comminuted fracture or separation, which is equivalentEvansId-classification or AO classification A2-2, A2-3; the U3classification:reverseintertrochanteric comminuted fractures, equals AO classification A3-3; U4classification:reverse intertrochanteric fractures, EvansII fractures and AO classification A3-1. Conclusion320-slice CT three-dimensional reconstruction can be more accurate anatomicalchanges of intertrochanteric fractures, more exactly reflect the real situation of the fracturesite, relative to the X-ray, X-ray showed stable fractures actually unstable fracture type, toguide clinical select the right treatment and biomechanics of internal fixation or prostheticreplacement provide an important basis, can effectively reduce and prevent the incidenceof surgical complications.