CAJ | 학술논문

目的探讨基于CT图像后处理技术的跟骨骨折术后三维形态学特征与踝-后足功能的相关性.方法 2009年12月至2012年1月,按预设纳入标准、排除标准、退出标准,收集来自五所医院的146例跟骨骨折术后患者的临床治疗信息及CT薄层扫描的原始数据,采用容积重建法观察跟骨距下关节面的恢复状况；采用表面重建法结合三维组合式测量模式测量跟骨形态学相关参数；将观察及测量结果与患者的美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足功能评分结果进行相关性分析.结果男、女性组的跟骨长度、跟骨后关节面高度、跟骨后关节面长度均与AOFAS评分无相关性.男、女性组Gissane角与AOFAS评分呈负相关,B(o)hler角呈正相关.在距下关节面平整性观察中,关节面完全恢复平整有38例,其中AOFAS评分优良率为89.5％(34/38);关节面不平整组有108例,优良率为90.7％(98/108)；两组间差异无统计学意义.结论跟骨骨折后的Gissane 角、B(o)hler角对踝-后足功能恢复的影响较大；而跟骨长度、跟骨后关节面高度、跟骨后关节面长度及跟骨距下关节面的平整性与踝-后足功能恢复无相关性.
목적 탐토기우CT도상후처리기술적근골골절술후삼유형태학특정여과-후족공능적상관성.방법 2009년12월지2012년1월,안예설납입표준、배제표준、퇴출표준,수집래자오소의원적146례근골골절술후환자적림상치료신식급CT박층소묘적원시수거,채용용적중건법관찰근골거하관절면적회복상황；채용표면중건법결합삼유조합식측량모식측량근골형태학상관삼수；장관찰급측량결과여환자적미국족과외과협회(American Orthopaedic Foot and Ankle Society,AOFAS)과여후족공능평분결과진행상관성분석.결과 남、녀성조적근골장도、근골후관절면고도、근골후관절면장도균여AOFAS평분무상관성.남、녀성조Gissane각여AOFAS평분정부상관,B(o)hler각정정상관.재거하관절면평정성관찰중,관절면완전회복평정유38례,기중AOFAS평분우량솔위89.5％(34/38);관절면불평정조유108례,우량솔위90.7％(98/108)；량조간차이무통계학의의.결론 근골골절후적Gissane 각、B(o)hler각대과-후족공능회복적영향교대；이근골장도、근골후관절면고도、근골후관절면장도급근골거하관절면적평정성여과-후족공능회복무상관성.
Objective To find out the correlation of the ankle-hindfoot function to the three-dimensional morphological characteristic of calcaneal fractures after surgical treatments based on the post-processing technique of CT images.Methods From December 2009 to January 2012,the original data of clinical information and CT scan of 146 patients with calcaneal fractures was collected in five hospitals according to the inclusion criteria,the exclusion criteria and the exit criteria.The original data was scanned by 16-detector row CT scanner and the clinical information was collected from five hospitals.The restoration of the subtalar facet was observed with the volume renderings.The surface shaded display (SSD) reconstruction combining three-dimensional measurement was utilized to measure the calcaneus related morphological parameters.The correlation study was carried out between the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the outcome after observation and measurement was analyzed.Results No significant correlation was found between the AOFAS score and the length of the calcaneus,the height of the posterior facet and the length of the posterior facet in male and female group.A significant inverse correlation was found between the Gissane angle and the AOFAS score in male group as well as in female group.A significant positive correlation was found between the B(o)hler angle and the AOFAS score in male group as well as in female group.The congruity of the subtalar joint was observed in 38 cases,and the excellent and good rate of the AOFAS score was 89.5％.Unflat articular surface was found in 108 cases,and the excellent and good rate of the AOFAS score was 90.7％.Conclusion The restoration of ankle-hindfoot function was affected largely by part of angular parameters after calcaneal fractures,such as the Gissane angle and the Gissane angle; nevertheless part of morphological parameters and the congruity of the subtalar facet had no correlation to the restoration of ankle-hindfoot functions.