目的 探讨数字化虚拟可视技术在跟骨关节内骨折分型的可行性与价值。方法 17例跟骨关节内骨折患者CT扫描数据集导入相应软件,重建跟骨骨折三维可视模型。2名高年资骨科医师,在规定时间内完成对每例跟骨骨折的三维数字化分型和sander分型评估,使用Kapppa值计算相关度,比较两种分型的可信度差别。结果 重建了15个跟骨骨折的数字化三维可视模型,准确地反映了跟骨骨折的解剖部位、骨折移位的方向和程度,数字分型的可信度Kapppa值为0.795(0.691~0.874),属于可信程度, sander分型的Kapppa值为0.641(0.591~0.701),属于基本可信程度。结论 基于数字化三维重建的跟骨骨折的分型直观明了,具有较高的可信度、为临床诊治方式的选择提供了更为精准的影像学依据。
Objectives To investigate the feasibility and value of digitalized visualization in the fracture classification of calcaneal fracture. Methods Seventeen cases of calcaneal fractures underwent multidetector CT scan. Three-dimensional reconstruction of visible models of these fractures were performed with the mimics 10.0 software on the basis of CT raw data. Two Senior orthopaedics surgeons class the fractures by Sander's criteria and digitalized criteria. The reliability between the criteria was compared using Kappa value. Results 17 three-dimensional visible models were established. The anatomic site, direction and degree of dislocation of fracture were demonstrated accurately. The Kappa value of digitalized criteria was 0.795(0.691~0.874), which was 0.641(0.591~0.701)in Sander's criteria. Conclusion Digitalized three-dimensional reconstruction can give intuitive and clear result in calcaneal fracture and classification. Its reliability is high. It will provide precise imaging basis for surgical plan.