골반골절에 있어서 3D-CT의 역할

Abstract

Purpose： To evaluate the usefulness of 3D-CT in the assessment of pelvic fracture.

Material & Methods: Consecutive 46 patients with pelvic fracture who investigated by both plain radiography and CT were included in analysis, 13 of 46 patients had pelvic fracture only, other 13 patients of 46 patients had acetabular fracture only, and remained 20 patients had combined fractures. We analysed the findings of 3D-CT images, and compared with plain radiography and axial CT images. Pelvic fractures were classified according to Young-Burgress classification and acetabular fractures were placed into categories of Letournel-Judet classification.

Result: According to the Young-Burgess classification, there were 14 AP compression fractures(42%), 10 lateral compression fracture(30%), six complex fractures(18%) and three vertical shearing (9%). In acetabular fractures, elementary fracture consisted of nine anterior wall fractures(26%), eight posterior wall(24%), six transverse(18%), two posterior column(6%) and two anterior column fractures(6%). Associated fracture was found in seven patients(21%)‘ In plain radiographs, we misled normal as fracture in seven patients, and sacroiliac joint diasthesis as normal in two patients. In 42 of 46 patients(96%), the findings of 3D-CT and axial 2D-CT are concurrent. One transverse fracture of pubic ramus and one small chip fracture of acetabulum were missed on 3D-CT. In 3D-CT, we could understand fracture mechanism and fragment displacement more precisely.

Conclusion: Although it is possible to classify the fracture type in each case from the plain radiographs and axial CT scan, the 3D-CT seems to be the easier and reliable modality for assessment of the fracture and for understanding mechanism of fracture, and seems to be helpful in preoperative planning.