MRI在足球运动员踝骨骨折诊断和预后判断中的应用

doi:10.7517/issn.1674-0475.220102

摘要/Abstract

摘要： 本文探讨MRI影像技术在足球运动员踝骨骨折诊断中的价值及术后骨性结构相关性。选取95例足球运动员踝骨骨折患者作为研究对象，均行MRI检查。以手术或关节镜检查结果为"金标准"，MRI诊断足球运动员踝骨骨折的准确率为94.74%，诊断踝骨骨折分型、分度与手术或关节镜检查结果的Kappa值分别为0.844、0.861（P<0.05）；踝关节恢复情况为优的患者，内踝间隙、TT、ATT的Δ1（术前与术后1个月变化值绝对值）均>良患者>可/差患者（P<0.05）；内踝间隙、TT、ATT的Δ1与足球运动员踝骨骨折患者踝关节恢复情况呈正相关（P<0.05）。MRI在足球运动员踝骨骨折诊断方面具有较高准确性，且能准确评估患者手术前后骨性结构变化情况，有助于指导临床制定完善的治疗计划。

关键词: 踝骨骨折, 足球运动员, 磁共振成像, 诊断, 骨性结构

Abstract: The purpose of this study was to investigate the value of MRI imaging technology in the diagnosis of ankle fractures for football players and the correlation of postoperative skeletal structures. Ninety-five football players with ankle fractures were selected as research subjects, and all underwent MRI examination. Taking the results of surgery or arthroscopy as the "gold standard", the accuracy rate of MRI in diagnosing ankle fractures in football players was 94.74%, and the Kappa values of the diagnosis of ankle fracture classification and classification with the results of surgery or arthroscopy were 0.844 and 0.861 (P<0.05). The Δ1 (absolute value of changes before and 1 month after operation) of medial ankle space, TT, and ATT in patients with excellent ankle joint recovery were all>good patients>fair/poor patients (P<0.05). Δ1 of medial malleolus, TT and ATT were positively correlated with the ankle joint recovery in football players with ankle fractures (P<0.05). MRI has high accuracy in diagnosing ankle fractures in football players, and can accurately assess the changes of bone structure in patients before and after surgery, which is helpful to guide the clinical formulation of a comprehensive treatment plan.

Key words: ankle fracture, football player, MRI, diagnosis, bony structure

刘东旭, 李佳怡, 唐昭明. MRI在足球运动员踝骨骨折诊断和预后判断中的应用[J]. 影像科学与光化学, 2022, 40(4): 976-980.

LIU Dongxu, LI Jiayi, TANG Zhaoming. Application of MRI in the Diagnosis and Prognosis of Ankle Fractures for Football Players[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(4): 976-980.

参考文献

[1] Mulcahey M K, Bernhardson A S, Murphy C P, et al. The epidemiology of ankle injuries identified at the national football league combine, 2009-2015[J]. Orthopaedic Journal of Sports Medicine, 2018,6(7):2325967118786227.
[2] 钱纪云, 叶强. 青少年足球运动员踝关节损伤的致因分析及康复案例研究[J]. 文体用品与科技, 2021,6(6):25-27, 30.
[3] 成红娟, 董浩宇. 长治市青少年足球运动损伤调查分析及预防[J]. 科技资讯, 2020,18(15):230, 232.
[4] Bäcker H C, Vosseller J T, Bonel H, et al. Weightbearing radiography and MRI findings in ankle fractures[J]. Foot & Ankle Specialist, 2021,14(6):489-495.
[5] 冯国洋, 郭龙军, 王娟, 等. MRI参数对腰椎间盘突出症患者椎间盘退变程度的评估价值及与JOA、VAS评分相关性[J]. 影像科学与光化学, 2021,39(2):207-212.
[6] 娄志堃, 刘斌成. Lauge-Hansen分型及踝关节损伤治疗[J]. 辽宁中医杂志, 2007,34(4):460-461.
[7] 卢景波, 李实. 足球运动员运动损伤的原因及康复对策[J]. 中国实验诊断学, 2019,23(12):2142-2143.
[8] D'Hooghe P, Grassi A, Alkhelaifi K, et al. Return to play after surgery for isolated unstable syndesmotic ankle injuries (west point grade IIB and III) in 110 male professional football players:A retrospective cohort study[J]. British Journal of Sports Medicine, 2020,54(19):1168-1173.
[9] 黄瑜玫, 陈位, 陈本宝. MRI与CT后处理技术对踝关节隐匿性骨折的诊断价值比较[J]. 浙江创伤外科, 2020,25(1):149-150.
[10] 卢小爱, 赵晓君, 葛怀志, 等. CT及MRI在踝关节骨折患者分型、分度及疗效评估中的应用价值[J].浙江创伤外科, 2019,24(6):1274-1275.
[11] Claassen L, Yao D W, Ettinger S, et al. Relevance of SPECT-CT in complex cases of foot and ankle surgery:A comparison with MRI[J]. Foot & Ankle Specialist, 2020,13(6):451-462.
[12] 余冬平, 魏国文. MRI在踝关节骨折伴发韧带损伤诊断中的应用价值[J]. 实用临床医学, 2019,20(3):59-62, 108.
[13] Sun L K, Liu H, Xu C T, et al. 3D printed navigation template-guided minimally invasive percutaneous plate osteosynthesis for distal femoral fracture:A retrospective cohort study[J]. Injury, 2020,51(2):436-442.
[14] Aytekin K, Balta O, Şahiner G G, et al. Minimally invasive surgical approach using an equal-sized plate as an external guide to lateral malleolar fractures[J]. Journal of the American Podiatric Medical Association, 2019,109(5):367-373.
[15] 孙剑波, 王磊. 切开复位内固定术联合韧带修复治疗踝关节骨折合并三角韧带Ⅱ度损伤的效果[J]. 临床医学研究与实践, 2019,4(21):44-46.
[16] Xie K, Han X Q, Jiang X, et al. The effect of varus knee deformities on the ankle alignment in patients with knee osteoarthritis[J]. Journal of Orthopaedic Surgery & Research, 2019,14(1):134.
[17] 陈国平. MRI诊断在踝关节后方撞击综合征中的应用价值[J]. 影像研究与医学应用, 2020,4(8):211-212.
[18] 李鹏, 杨锁平. 闭合复位经皮微创内固定术治疗踝关节骨折的效果及对踝关节结构及功能的影响[J]. 临床医学研究与实践, 2019,4(17):48-49, 88.