跖跗关节损伤的CT影像学特征研究的临床调查△（开放获取）

A clinical investigation on CT imaging characteristics of tarsometatarsal injuries

摘要:

[目的]探讨跖跗关节损伤的CT影像学表现特征。[方法]选取2017年5月—2018年10月本院门急诊收录的跖跗关节损伤CT影像学资料并进行回顾性分析，记录性别、年龄、分型及损伤类型、损伤特征、合并损伤等数据，进行归纳汇总。[结果]共307例（309足）CT数据纳入本研究，其中男性200例，女性107例，平均年龄（44.7±15.5）岁。损伤最常见于18~30岁人群（66例）。根据三柱分型理论，三柱损伤者最多，共154足，且中间柱受累率最高，共297足。根据柱内及柱间亚型，柱内损伤最多见，而单纯柱间损伤发生率最低。所有患者中，轻微损伤11足、多发脱位2足、骨折-脱位70足；合并楔骨骨折239足、跖骨骨折287足、骰骨骨折89足。复合体损伤78足、累及跗横关节者15足。[结论]跖跗关节损伤以男性中、青年多见，损伤影像学表现类型多样，三柱损伤及柱内损伤最常见，且中间柱受累率高；跖跗关节损伤合并内侧楔骨骨折发生率高，临床诊治中应予以重视。

Abstract:

[Objective] To explore the CT imaging characteristics of tarsometatarsal injuries by a clinical survey. [Methods] A retro-spective study was conducted on CT data of tarsometatarsal injuries taken from May 2017 to October 2018. In addition, the documents re-garding gender, age, classification and injury pattern, associated injuries, characteristics of injuries were recorded and summarized. [Results] A total of 307 patients (309 feet) were enrolled into this study, involving 200 males and 107 females. In term of age, the tarsometatar-sal injuries most commonly occurred in 18 to 30 years old (66/307 cases). In term of three-column classification system, the majority caseswere of three-column injuries (154/309 feet), with the middle column involved most frequently (297/309 feet). In terms of the intra-columnand inter-column sub-classification, the intra-column injury was most common, while inter-column injury had the lowest incidence. In allthe patients, the subtle injuries were seen in 11 feet, fracture-dislocation in 70 feet, pure dislocation in 2 feet, while combined cuneiformfractures were found in 239 feet, metatarsal fractures in 287 feet, cuboid fracture in 89 feet. Chopart joint involved in 15 feet and tarsometa-tarsal complex injuries in 78 feet. [Conclusion] Tarsometatarsal injury was most commonly seen in young and male patients. The CT imag-ing characteristics varies considerably, the three column and intra-column was most common with a highest rate of middle column in-volved. Furthermore, the tarsometatarsal injuries have a high incidence of associated medial cuneiform fractures, which is necessary to paya great attention during the diagnosis and treatment.