X射线断层融合技术对股骨颈骨折股骨颈动力交叉钉系统内固定后疗效评估的价值
Value of X-ray tomographic fusion technique in effect assessing after FNS internal fixation of femoral neck fracture
张浩然 1吴京亮 1张从笑 1魏更生1
作者信息
- 1. 北京市海淀医院骨科 北京 100080
- 折叠
摘要
目的:通过常规X射线与X射线断层融合成像两种影像技术的比较,探讨X射线断层融合技术对股骨颈骨折股骨颈动力交叉钉系统(FNS)内固定后骨愈合和骨痂生长情况评估的应用价值.方法:选取2019年10月至2020年6月北京市海淀医院骨科收治的18例股骨颈骨折患者,所有患者均采用FNS内固定治疗,分别于术后1个月和12个月时行普通X射线和X射线断层融合成像,评价两种影像技术对股骨颈骨折FNS内固定术后骨愈合和骨痂生长情况的显示情况,统计两种影像技术对股骨颈骨折FNS内固定图像检测过程的相关参数.结果:在股骨颈骨折患者术后1个月时X射线断层融合成像技术的骨痂检出率均低于术后12个月,且X射线断层融合技术在患者术后1个月和12个月时的骨痂检出率(94.44%和61.11%)均高于X射线(61.11%和33.33%),差异有统计学意义(x2=5.100、5.790,P＜0.05);经秩和检验显示,两种影像技术在股骨颈骨折患者术后1个月和12个月时的骨痂生长情况图像质量评分分布差异有统计学意义(Z=2.113,2.018,P＜0.05),两种影像技术的术后1个月和12个月骨愈合图像质量比较,差异有统计学意义(Z=2.868、2.258,P＜0.05);X射线断层融合技术成像引导的治疗前骨折处检测影像图显示效果理想,图像清晰,较完整清晰地显示出患者的骨折线,术后12个月X射线正侧位可见连续性骨痂通过骨折线,达临床愈合;X射线断层融合技术对股骨颈骨折FNS内固定图像检测过程的空气比释动能、剂量面积乘积以及有效剂量均低于常规X射线成像,差异均有统计学意义(t=5.900、2.466、32.255,P＜0.05).结论:在对股骨颈骨折FNS内固定后患者骨愈合情况的诊断评价中,使用X射线断层融合技术能够更好地对患者的骨痂生长情况进行检测,判定骨愈合程度,尤其是对术后恢复时间更长的判定效果更佳,且安全性较好,在检测过程中辐射损伤较小.
Abstract
Objective:To explore the application value of X-ray tomographic fusion technique in assessing bone healing and osteotylus growth after femoral neck system(FNS)internal fixation of femoral neck fracture.Methods:A total of 18 patients with femoral neck fracture who admitted to the Department of Orthopedics of Beijing Haidian Hospital from October 2019 to June 2020 were selected.All of them were treated with FNS internal fixation,and conventional X-ray and X-ray tomographic fusion imaging were performed respectively at 1 month and 12 months after operation for them.The displays of the two imaging techniques for the bone healing and osteotylus growth after FNS internal fixation of femoral neck fracture were evaluated,and the relevant parameters of the two imaging techniques for the process of image detection of FNS internal fixation of femoral neck fracture were counted by statistical method.Results:The detection rate of X-ray tomographic fusion technique for osteotylus at 1 month after surgery was significantly lower than that at 12 months after surgery.The detection rates(94.44% and 61.11%)of X-ray tomographic fusion technique for osteotylus at 1 month and 12 months after surgery were significantly higher than those(61.11% and 33.33%)of X-ray(x2=5.100,5.790,P<0.05),respectively.The rank-sum test indicated there were significant differences in the distribution of the scores of the image qualities of osteotylus growths at 1 month and 12 months after surgery for patients with femoral neck fracture between two imaging techniques(Z=2.113,2.018,P<0.05),and there were significant differences in the image qualities of bone healing at 1 month and 12 months after surgery between two imaging techniques(Z=2.868,2.258,P<0.05).The display effect of the detection image of fracture site before treatment under the guidance of X-ray tomographic fusion technique was ideal,which images were clear and could display more fully and clearly the fracture line of patient.After 12 months of surgery,the continuous osteotylus that passed fracture line could be found at the anterior lateral position of X-ray,which has reached to clinical healing.In the process of detecting image of FNS internal fixation of femoral neck fracture,the air Kerma,dose area product and effective dose of X-ray tomographic fusion technique were significantly lower than those of conventional X-ray imaging(t=5.900,2.466,32.255,P<0.05),respectively.Conclusion:In the diagnosis and evaluation of bone healing of patients with FNS internal fixation after femoral neck fracture,the use of X-ray tomographic fusion technique can better detect the osteotylus growth of patients and judge the degree of bone healing,especially the judgment effect of that for the postoperative recovery with longer time of patients is more better.In addition,this technique has better safety,which would cause less radiation damage in the process of detection.
关键词
X射线断层融合技术/股骨颈骨折/股骨颈动力交叉钉系统内固定/骨愈合/骨痂生长情况Key words
X-ray tomographic fusion technique/Femoral neck fracture/Femoral neck power cross nail system internal fixation/Bone healing/Osteotylus growth引用本文复制引用
基金项目
北京市2022年度培育计划(PX2022051)
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据