基于CT的髌骨下极骨折分型

doi:10.13418/j.issn.1001-165x.2021.06.005

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中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (6) : 646-648. DOI: 10.13418/j.issn.1001-165x.2021.06.005

断层影像解剖

基于CT的髌骨下极骨折分型

许福生，张伟，牛飞，程安源，夏平

作者信息 +

Fracture classification for distal pole of patella fractures based on CT

Xu Fusheng, Zhang Wei, Niu Fei, Cheng Anyuan, Xia Ping

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摘要

目的基于三维CT图像对髌骨下极骨折分型。方法回顾性分析本院2018年5月至2020年11月67例髌骨下极骨折的三维CT图像并分型。用Kappa系数评估观察者间可信度和观察者自身可信度。结果髌骨下极骨折分为无移位骨折（Ⅰ型）和移位骨折（Ⅱ型）两型。移位骨折可分为3个亚型：Ⅱa型，大块型骨折，包括髌骨下极1枚孤立性骨折块，或2枚较大的骨折块；Ⅱb型，粉碎性骨折，多枚较小的骨折块，包括冠状位和矢状位骨折块；Ⅱc型，袖套样撕脱骨折，沿髌骨下极整个弧面的呈内外方向的长弧形骨折，多为粉碎性的，骨折块非常薄。本研究中Ⅰ型8例，Ⅱa型11例，Ⅱb型42例，Ⅱc型6例。观察者之间的可信度平均K值为0.782（0.682 ~ 0.896），基本可信；观察者自身可信度平均K值为0.837（0.786 ~ 0.884），完全可信。结论本文髌骨下极骨折分型方法有较高的可信度及可重复性，对临床有一定的指导意义。

Abstract

Objective　To perform classification the distal pole fractures of patella based on three-dimensional CT.　Methods　 From May 2018 to November 2019, a retrospective analysis of 67 cases of the distal pole fractures of patella were classified by three-dimensional CT. The Kappa coefficients (K) was utilized to assess inter-observer and intra-observer reliabilities.　Results　The distal pole fractures of patella was divided into two types: a non-displaced fracture (type I) and a displaced fracture (typeⅡ).The displaced fracture was further divided into the following three subtypes: Type Ⅱa ( massive fractures, including one isolated fracture or two larger fractures), Type Ⅱb (comminuted fractures, multiple smaller fractures, including coronal plane and sagittal plane fractures), Type Ⅱc (cuff-like avulsion fractures, avulsion fractures along the entire arc of distal pole of patella, most of the fractures were comminuted and very thin). There were 8 cases of type I, 11 cases of type Ⅱa, 42 cases of type Ⅱb, and 6 cases of type Ⅱc under this study. The average K value of the inter-observer reliability was 0.782 (range 0.682~0.896), which was substantial agreement, and the average K value of the intra-observer reliability was 0.837 (range 0.786~0.884), which was perfect agreement. Conclusions　The CT classification for the distal pole fractures of patella has high reliability and repeatability. It is simple and easy to remember, and has certain clinical implication.

导出引用

许福生, 张伟, 牛飞, 程安源, 夏平. 基于CT的髌骨下极骨折分型[J]. 中国临床解剖学杂志. 2021, 39(6): 646-648 https://doi.org/10.13418/j.issn.1001-165x.2021.06.005

Xu Fusheng, Zhang Wei, Niu Fei, Cheng Anyuan, Xia Ping. Fracture classification for distal pole of patella fractures based on CT[J]. Chinese Journal of Clinical Anatomy. 2021, 39(6): 646-648 https://doi.org/10.13418/j.issn.1001-165x.2021.06.005

中图分类号： R683.42

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