Application Of X-Ray, CT Three-dimensional Reconstruction And MRI In Diagnosis Of Tibial Plateau Fracture

Objective:Compare with the effect of diagnosis and treatment of tibial plateau fractures between common X-ray,CT three-dimensional reconstruction and Magnetic Resonance Imaging to explore the clinical value of these three techniques in diagnostic classification,providing more effective ways for the diagnosis of tibial plateau fractures.Methods:Select32patients diagnosed with tibial plateau fractures,and analyze their clinical data.All patients had undergone the examination of common X-Ray,CT three-dimensional reconstruction,and MRI.Compare and analyze the results, including that whether there exists obvious difference,and how they can guide us in the clinical work,and expenditure of the three examinations.Results:All patients with CT three-dimensional reconstruction and MRI scan well illustrate the fracture line,the shift of the broken end,the position of the bone fragments,and the degree of collapse of the articular surface.In the mean time,all the MRI images perfectly show the damage of soft tissue and the structure of the knee joint,which includes the fracture of articular cartilage,meniscus tear,or shift,the injury of cruciate ligament and lateral ligamentous. In regard to accuracy of the diagnosis of fractures,the solo X-Ray check makes a definite diagnosis of28cases,2cases of suspicious,3cases of misdiagnosis,which presents a positive rate of87.5%;After the CT three-dimensional reconstruction with31cases of confirmation and1case of suspicious,the positive rate reaches96.9%;As to the MRI check,the positive rate is100%.Compare X-ray with CT three-dimensional reconstruction check,P<0.05.Compare X-ray with MRI check,P<0.05as well.Compare CT with MRI check,P>0.05.As regards with the classification,in the three examinations via Schatzker classification,compare the X-ray with CT three-dimensional reconstruction check,P>0.05;compare the X-ray with MRI scan,P>0.05;compare the CT and MRI check,P>0.05;With respect to the diagnosis of soft tissues,in the32caese diagnosed with MRI scan,19patients are confirmed existing the soft tissue injury,which includes1case of anterior cruciate ligament rupture,6cases of medial collateral ligament injury,5cases of lateral collateral ligament injury,8cases of meniscus injury and12cases of arthroedema out of all the19cases.while the CT and X-Ray don’t.As for the examination cost of all the patients compared,there exists significant difference between X-ray check and the other two,and P<0.05.The same situation exists between the CT three-dimensional reconstruction and MRI check.Conclusion:X-ray combined with CT examination in the diagnosis of fracture of tibial plateau and parting coincidence rate is higher.X-ray combined with CT and MR examination can clearly display not only fracture,but articular cartilage,epiphyseal plate cartilage, meniscus and tendon ligament damage.The patients undertake better clinical curative effect,but higher inspection cost.When there happens tibial plateau fracture,X-ray plain film, CT three-dimensional reconstruction and MR scan all can be used as a preoperative routine inspection.