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目的探讨跗跖关节骨折脱位的多层螺旋CT特征表现。资料与方法跗跖关节骨折脱位患者23例,其中直接暴力损伤者10例,间接暴力损伤者13例。应用多平面重组(MPR)、曲面重组(CPR)、表面遮盖显示技术(SSD)及容积再现(VRT)重组技术进行图像后处理。结果单纯骨折6例,骨折合并跗跖关节失去正常对应关系17例,其中10例关节面错位≤2mm,3例骨折既合并>2mm的关节错位又有≤2mm的关节面错位。第2跖骨基底与内侧楔状骨间隙增宽,提示Lisfranc韧带损伤14例。结论骨折(以第2、3跖骨基底骨折最常见,以跖侧常见)、关节面错位和Lisfranc韧带损伤可为跗跖关节骨折脱位多层螺旋CT扫描的特征表现。
Objective To investigate the multi-slice spiral CT features of tarsometatarsal joint fractures and dislocations. Materials and Methods Twenty - three patients with tarsometatarsophageal fractures and dislocations were involved, including 10 cases of direct violence and 13 cases of indirect violence. Image postprocessing is performed using multi-planar rebuild (MPR), surface rebuild (CPR), surface covered display (SSD) and volumetric rebuild (VRT) recombination techniques. Results There were 6 simple fractures, and the other 17 fractures with tarsometatarsal joint lost their normal corresponding relationship. Among them, 10 had articular surface dislocation ≤ 2 mm, and 3 had dislocation of joint> 2 mm and articular surface dislocation of ≤ 2 mm. The second metatarsal base and the medial wedge bone gap widened, suggesting Lisfranc ligament injury in 14 cases. Conclusions Fractures (the most common metatarsal basement fractures on the second and third metatarsal bases and common on the plantar side), the dislocation of the articular surface and the ligament damage of Lisfranc may be characteristic features of multi-slice spiral CT in the fracture and dislocation of the tarsometatarsal joint.