Gãy mâm chày - Vai trò của chụp cắt lớp vi tính, so sánh với phim X-quang qui ước

Purpose: Evaluate the contributed role of Multislice (MSCT) in managing tibial plateau fractures, dassification and established the most appropriate therapeutic treatment compared to conventional radiology. Patients Demographics: 126 patients with 126 tibial plateau fractures were classified by Schatzker scale systemsat orthopaedic and injury department, No.175 Hospital. There are sixty-two closing fracture were fixed with plate and screw. All the patients have X-rays and medical reports, multislide CT-scan. Methods: Prospective and retrospective study, seri-description. On adminisstrion, all the patients were take conventional X-rays in lateral and frontal position. Then, CT Scan were taken. MSCT were taken from distal femur and proximal tibia and 3D reconstruction tibial plateau fractures. The following radiographic and MSCT parameters were used: shape of tibial plateau fractures, degree and location of depression, location fracture at the posterior tibial plateau wall, plan of treatment before and after take MSCT. Determine the confidence scale systems (Schatzker, AO-ASIF or Hohl). Results: According to the Schatzker scale: showed agreement in 86,61 percent cases and disagreement in 13,39 percent. Among three scale systems, the Schatzker scale was the most of confidence next was Hohl scale system and at least was AO-ASIF, MSCT showed degree, location and region of depression better than plain X-rays. In tranverse plane, MSCT showed number and location of fragment, location of depression, especially fragments at the posterior wall of tibial plateau. The rate modify the treatment by MScr was 19,3 percent (12 patients) include: change approach and position of the plate: 7 patients; suggested double two plate: 3 patients, MSCT demonstrated bone tissue loss and suggesting for bone autograft: 2 patients. The plain radiology demonstrated not exactly degree of depression, esspecially medial tibial plateau. The 3D reconstruction technique enable evaluating rotation of fractured fragments as it provides an overall view of the fracture line. Conclusion: MSCT and 3D reconstructions are very useful for classify and assess degree of injury tibial plateau fractures preoperative. Patients with tibial plateau fractures (Schatzker type V,VI) need take MSCT preoperative.