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首页> 外文期刊>Injury >The pivotal role of the coronal fracture line for a new three-dimensional CT-based fracture classification of bicondylar proximal tibial fractures
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The pivotal role of the coronal fracture line for a new three-dimensional CT-based fracture classification of bicondylar proximal tibial fractures

机译：冠状骨折线对Bicondylar近端胫骨骨折的新三维CT基断裂分类的枢轴作用

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Abstract Introduction Classical fracture classifications (AO/OTA, Schatzker) are commonly used to characterize bicondylar proximal tibial fractures. However, none of these classifications allows for a treatment algorithm. The aim of our study was to use 3D appearance of these fractures in CT imaging to improve the clinical value of the classification. Materials and methods 3D appearance of 81 CT scans of bicondylar proximal tibial fractures were systematically analyzed and were classified in 3 subtypes, based on the fracture lines orientation. The novel classification was compared for reliability and for clinical relevance with AO and Schatzker classification. Results A total of 159 fracture lines were identified which were most frequently oriented in sagittal (89/159), and in coronal (41/159) direction. Based on the orientation of the major fracture lines three fracture types were defined. A special emphasis was drawn to the coronal fracture line of the medial plateau leading to a surgical treatment algorithm. Interobserver reliability was analyzed for all 81 patients resulting in an excellent reliability of К =0.936 for the 3D classification scheme compared to К =0.720 for the AO/OTA, К =0.785 for the Schatzker classification. Correlations with clinical parameters were only observed for the 3D classification. Discussion The presented classification scheme based on the 3D geometry of bicondylar proximal tibial fractures demonstrates a good reliability of clinical relevance. ]]>
机译：摘要介绍古典骨折分类（AO / OTA，Schatzker）通常用于表征双手间近端胫骨骨折。但是，这些分类都没有允许治疗算法。我们的研究目的是在CT成像中使用这些骨折的3D外观，以改善分类的临床价值。基于裂缝线取向，系统地分析了材料和方法的3D外观81 CT扫描的BICondyLAR近端胫骨骨折。比较新的分类，以便可靠性和与AO和Schatzker分类的临床相关性。结果鉴定了总共159条骨折线，其在矢状（89/159）中最常导致，并在冠状（41/159）方向上。基于主要骨折线的定向，定义了三种裂缝类型。特别强调内侧高原的冠状骨折线，导致外科治疗算法。针对所有81名患者分析了Interobserver可靠性，导致3D分类方案的К= 0.936的优异可靠性与Schatzker分类的AO / OTA，К= 0.785相比，3D分类方案相比。仅针对3D分类观察到与临床参数的相关性。讨论基于BicondyLar近端胫骨骨折的3D几何形状的呈现的分类方案表明了临床相关性的良好可靠性。 ]]>

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