OSTEOCHONDRAL FRACTURES OF THE DOME OF THE TALUS
OSTEOCHONDRAL FRACTURES OF THE DOME OF THE TALUS
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DOI：
10.2106/00004623-198971080-00004
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发表时间：
1989-09-01
影响因子：
5.3
通讯作者：
BRAZIER, D
中科院分区：
文献类型：
--
作者：
ANDERSON, IF;CRICHTON, KJ;BRAZIER, D
对24例距骨圆顶骨软骨骨折的患者进行了X线平片、磁共振成像、计算机断层扫描和（如有指征）骨造影检查。当依靠踝关节平片诊断距骨骨软骨骨折时，许多病变仍未确诊。I期骨接触性骨折在平片上没有诊断变化，II期病变通常很细微，因此经常被放射科医生和临床医生忽视。骨关节造影术作为一种筛查方法，磁共振成像对骨关节造影阳性的患者的应用表明，骨软骨骨折比以前文献中指出的更常见。当临床上怀疑有骨软骨骨折，但平片显示阴性时，应使用闪烁照相术对患者进行评估。磁共振检查阳性的患者应通过磁共振成像进行评估。X线平片异常的患者不会从磁共振成像中获得重大益处;除了其中一名患者外，计算机断层扫描足以对骨折进行分期。
Twenty-four patients who had an osteochondral fracture of the dome of the talus were examined by plain radiography, magnetic resonance imaging, computerized tomography, and, when indicated, scintigraphy. When plain radiographs of the ankle are relied on for the diagnosis of an osteochondral fracture of the talus, many lesions remain undiagnosed. Stage-I osteocondral fractures show no diagnostic changes on plain radiographs, and Stage-II lesions are usually subtle and, therefore, are often overlooked by both radiologists and clinicians. The use of scintigraphy as a screening procedure and of magnetic resonance imaging for patients who have positive scintiscans showed that osteochondral fractures are more common than has previously been indicated in the literature. Scintigraphy should be used to assess patients when there is clinical suspicion of an osteochondral fracture but the plain radiographs appear to be negative. Patients who have positive scintiscans should be assessed by magnetic resonance imaging. Patients who have abnormal plain radiographs will derive no major benefits from magnetic resonance imaging; for all but one of these patients, computerized tomography was adequate for staging the fracture.