跟骨结节内侧突骨折与跟骨舌形骨折的关系△

Relationship between fracture of the medial process of the calcaneal tuberosity and tongue-type calcaneus fractures

摘要:

[目的] 采用图像测量并分析跟骨舌形骨折与跟骨结节内侧突骨折之间的关系。[方法] 回顾分析本院 2016 年 1 月 —2020 年 1 月期间诊治的 157 例跟骨骨折患者影像资料，根据 X 线片判断跟骨骨折的 Essex-Lopresti 分型，CT 重建图像评判跟骨结节内侧突骨折的发生及测量移位距离。[结果] 157 例中，舌形骨折型 73 例 (46.50%)，关节压缩型 48 例 (30.57%)， 另外 36 例为不可分类型(22.93%)。舌形骨折型合并跟骨结节内侧突骨折 34 例(46.58%)，关节压缩型合并跟骨结节内侧突骨折 11 例 (22.92%)，不可分类型中合并跟骨结节内侧突骨折 17 例 (47.22%)(P＜0.05)。舌形骨折型合并的跟骨结节内侧突骨折移位平均(5.12±0.71)mm，关节压缩型合并的跟骨结节内侧突骨折移位平均(4.83±0.33)mm，不同骨折类型间跟骨结节内侧突骨折位移差异无统计学意义(P＞0.05)。[结论]舌形骨折中发生跟骨结节内侧突骨折概率高于关节压缩型，且舌形骨折移位越大，越易合并跟骨结节内侧突骨折。

Abstract:

[Objective] To explore the relationship between fracture of the medial process of the calcaneal tuberosity (plantar medial avulsion, PMA fracture) and tongue-type fractures by radiographic measurement. [Methods] A retrospective study was conducted on imag- ing data of 157 patients who underwent treatment for calcaneal fractures in our hospital from January 2016 to January 2020. Radiographs and CT images were reviewed to determine the Essex-Lopresti classification and measure the fracture displacement. [Results] Of the 157 patients, tongue-type fracture (TT) was found in 73 cases, accounted for 46.50%; joint depression (JD) fracture was in 48 cases, accounted for 30.57%; while the fractures not classified by the Essex- Lopresti classification was seen in 36 cases, accounted for 22.93%. Among them, PMA fracture was noted in 34 patients of the TT group (46.58%) , 11 cases of JD group (22.92%) , whereas 17 cases of unclassified fracture group (47.22%) , which was statistically significant (P＜0.05) . The displacement of PMA fragment was of (5.12±0.71) mm in TT group, whereas (4.83±0.33) mm in the JD group, which was not statistically significant (P＞0.05) . [Conclusions] The tongue-type fracture has considerably higher chance to accompany with PMA fracture than the joint depression fracture. The more displacement of tongue frag- ment, the more possibility of combined PMA fracture.