天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (10): 1102-1106.doi: 10.11958/20211372

• 临床研究 • 上一篇    下一篇

踝关节正侧位和足正斜位X线检查诊断第5跖骨基底骨折的价值对比

童卫玲，杨桂华，张煜楠，辛玉静，白国杰，程悦
  

  1. 天津市北辰医院放射科（邮编300400）；2天津市北辰区中医医院放射科；3天津市第一中心医院影像中心
  • 收稿日期:2021-06-15 修回日期:2021-08-26 出版日期:2021-10-15 发布日期:2021-10-15
  • 通讯作者: 程悦 E-mail:xw3833@163.com

The comparison of anteroposterior and lateral view of ankle and anteroposterior and oblique view of foot in the diagnosis of the fracture of the fifth metatarsal base

TONG Wei-ling, YANG Gui-hua, ZHANG Yu-nan, XIN Yu-jing, BAI Guo-jie, CHENG Yue   

  1. 1 Department of Radiology, Tianjin Beichen Hospital, Tianjin 300400, China; 2 Department of Radiology, Tianjin Beichen
    Traditional Chinese Medicine Hospital; 3 Image Center of Tianjin First Central Hospital
  • Received:2021-06-15 Revised:2021-08-26 Published:2021-10-15 Online:2021-10-15

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摘要： 目的 分析踝关节正侧位及足正斜位X线检查在诊断第5跖骨基底骨折中的价值，优化检查流程。方 法 选取96例第5跖骨基底骨折患者，同时进行踝关节正侧位及足正斜位X线检查，比较4种投照体位下第5跖骨基 底骨折及Mehlhorn分型的显示情况。结果 96例患者中，86例在踝关节正位显示骨折，90例在踝关节侧位显示骨 折，65例在足正位显示骨折，83例在足斜位显示骨折。踝关节正侧位显示骨折率高于足正斜位（91.7% vs. 77.1%，χ2= 15.486，P＜0.01）。踝关节正位和踝关节侧位显示骨折率差异无统计学意义（89.6% vs. 90.0%，χ2=1.091，P＞0.05）。 踝关节正侧位对Ⅰ型和Ⅲ型骨折显示率优于足正斜位（Ⅰ型：92.9% vs. 71.4%，χ2=6.574；Ⅲ型：93.9% vs. 77.3%，χ2= 7.439，P＜0.05），两者对Ⅱ型骨折显示率比较差异无统计学意义（89.3% vs.79.8%，χ2=2.912，P＞0.05）。踝正位及侧 位显示Ⅰ型、Ⅱ型骨折差异无统计学意义（Ⅰ型：100.0% vs. 85.7%，χ2=3.231；Ⅱ型：85.7% vs. 92.9%，χ2=1.120，P＞ 0.05），显示Ⅲ型骨折差异有统计学意义（87.9% vs. 100.0%，χ2=4.258，P＜0.05）。结论 踝关节正侧位较足正斜位更 能清晰显示第5跖骨基底骨折，建议对足部扭伤后踝关节及第5跖骨基底处肿胀疼痛的患者首选拍摄踝关节正侧 位片。

关键词: 放射摄影术, 踝关节, 第5跖骨骨折, 投照方法

Abstract: Objective To analysis the value of X-ray examination in anteroposterior and lateral view of ankle and anteroposterior and oblique view of foot in the diagnosis of the fracture of the fifth metatarsal base, and optimize the inspection process. Methods A total of 96 patients with the fracture of the fifth metatarsal base were included in this study, and the X-ray examination was performed in the anteroposterior and lateral view of ankle and anteroposterior and oblique view of foot at the same time. The display of the fracture of the fifth metatarsal base in all 4 projections and the Mehlhorn classifications were analyzed. Results In all 96 patients, 86 patients showed the fracture in the anteroposterior view of ankle joint, 90 patients showed the fracture in the lateral view of ankle joint, 65 patients in the anteroposterior view of foot, and 83 patients showed the fracture in the oblique view of foot. The fracture rates of ankle joint in anteroposterior and lateral view were higher than those in the anteroposterior and oblique view of foot (91.7% vs. 77.1%, χ2=15.486, P＜0.01). There were no significant differences in fracture rates between the anteroposterior and lateral view of ankle joint (89.6% vs. 90.0%, 2χ =1.091, P＞0.05). For Mehlhorn classifications, the anteroposterior and lateral view of ankle joint showed better than those of the anteroposterior and oblique view of foot in type Ⅰand Ⅲ (typeⅠ: 92.9% vs. 71.4%, χ2=6.574; type Ⅲ: 93.9% vs. 77.3%, χ2=7.439, P＜0.05). There was no significant difference in typeⅡ between the both (89.3% vs.79.8%, χ2=2.912, P＞ 0.05). There was no significant difference in typeⅠand typeⅡ between the anteroposterior and lateral view of ankle (typeⅠ: 100.0% vs. 85.7%，χ2=3.231, typeⅡ: 85.7% vs. 92.9%, χ2=2.912, P＞0.05），but there was significant difference in type Ⅲ (87.9% vs. 100.0%, χ2=4.258, P＜0.05). Conclusion The anteroposterior and lateral view of ankle joint can show the fracture of the fifth metatarsal base clearly, and it is suggested anteroposterior and lateral view of ankle should be taken Xray examination for patients with swelling and pain at ankle joint.

Key words: radiography, ankle joint, fracture of the fifth metatarsal, radiographic method