【摘要】 目的 探究CT测量胫骨平台关节面塌陷深度(ADD)、胫骨平台增宽的宽度(TPW)参数对SchatzkerⅡ型胫骨平台骨折患者外侧半月板撕裂的评估价值研究。方法 回顾性分析2021年3月至2024年3月期间在我院骨科接受CT检查和相关治疗的80例SchatzkerⅡ型胫骨平台骨折患者的临床资料。根据治疗时关节镜检查是否同期存在外侧半月板撕裂进行分组，分别是撕裂组和非撕裂组，比较两组患者入院时ADD、TPW参数水平差异，采用受试者工作特征(ROC)曲线分析入院时ADD、TPW参数对SchatzkerⅡ型胫骨平台骨折患者发生外侧半月板撕裂的诊断效能。根据撕裂组的膝关节功能恢复情况[膝关节评分(HSS评分)]，分为优良亚组(HSS>70分)和较差亚组(HSS≤70分)，并经pearson相关系数分析CT测量ADD、TPW参数和HSS评分的相关性。结果 同期存在外侧半月板撕裂患者有49例(61.25%)；未存在外侧半月板撕裂患者有31例(38.75%)。入院时，两组一般资料的比较结果显示差异无统计学意义(P>0.05)。撕裂组的ADD、TPW水平显著高于非撕裂组(P<0.05)。经ROC分析，ADD、TPW单一指标检测及联合的ROC曲线下面积(AUC)值分别是0.827、0.857、0.920；标准误差(SE)值分别是0.0470、0.0457、0.0291；敏感度分别是93.55%、74.19%、80.65%；特异度分别是67.35%、91.84%、89.80%，差异具有统计学意义(P<0.05)。Pearson相关系数分析显示，SchatzkerⅡ型胫骨平台骨折外侧半月板撕裂患者ADD、TPW参数水平与HSS评分负相关(P<0.05)。结论 CT测量ADD和TPW对于评估SchatzkerⅡ型胫骨平台骨折患者发生外侧半月板撕裂的情况具有一定的参考价值，且这些参数与术后膝关节功能恢复情况呈负相关。更多还原

【Abstract】 Objective To explore the evaluated value of CT measurement of articular depression depth(ADD) and tibial plateau widening(TPW) on lateral meniscus tear in patients with Schatzker type Ⅱ tibial plateau fractu res.Methods Tne clinical data of 80 patients with Schatzker type Ⅱ tibial plateau fractures who received CT examination and related treatments in department of orthopedics of the hospital were retrospectively analyzed from March 2021 to March 2024.According to whether there was lateral meniscus tear at the same time during a rthroscopic examination during treatment,they were divided into tear group and non-tear group.The differences in ADD and TPW at admission were compared between groups.Receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficiency of ADD and TPW at admission on lateral meniscus tear in patients with Schatzker typeⅡ tibial plateau fractures.According to the recovery status of knee function [knee joint score(HSS score)],the patients in tear group were classified into excellent and good subgroup(HSS>70 points)and poor subgroup(HSS≤70 points).The correlation between ADD,TPW and HSS score was analyzed by pearson correlation coefficient.Results There were 49 patients(61.25%) with lateral meniscus tear during the same period,and there were 31 patients(38.75%) without lateral meniscus tear.At admission,there we re no statistical differences in general data between groups(P>0.05).The ADD and TPW in tear group were significantly higher than those in non-tear group(P<0.05).After ROC analysis,the areas under ROC curves(AUCs) of ADD,TPW and their combination were 0.827,0.857 and 0.920,the standard error(SE) values were 0.0470,0.0457 and 0.0291,the sensitivities were 93.55%,74.19%and 80.65%,and the specificities were 67.35%,91.84% and 89.80% respectively(P<0.05).Pearson correlation coefficient analysis showed that the ADD and TPW were negatively correlated with HSS score in patients with Schatzker type Ⅱ tibial plateau fractu res complicated with lateral meniscus tear(P<0.05).Conclusion CT measurement of ADD and TPW has certain reference value on evaluating the occurrence of late ral meniscus tear in patients with Schatzker type Ⅱ tibial plateau fractures,and these pa rameters are negatively correlated with postoperative knee function recove ry.更多还原