目的

评估低剂量CT容积扫描联合三维重建在股骨粗隆间骨折分型中的应用价值。

方法

回顾性收集2023年3月至2024年3月收治的股骨粗隆间骨折患者107例，男性62例，女性45例，平均年龄（43.82±10.91）岁。所有患者均在术前进行低剂量CT容积扫描联合三维重建检查与X线平片检查，比较低剂量CT容积扫描、X线平片与手术实际探查的分型状况与骨折块数量探查的差异。

结果

低剂量CT容积扫描联合三维重建诊断股骨粗隆间骨折分型的总体准确率为87.85%，具体到Ⅰ型及各个分期至Ⅱ型，准确率分别为84.38%、88.46%、88%、88.24%、100.00%，且一致性检验Kappa值为0.867（P＜0.05）。X线平片诊断股骨粗隆间骨折分型的总体准确率为78.50%，具体到Ⅰ型及各个分期至Ⅱ型，准确率分别为75.00%、76.92%、80.00%、82.35%、85.71%，Kappa值为0.753（P＜0.05）。低剂量CT容积扫描联合三维重建所识别的骨折块数量虽少于手术探查发现的，但这种差异统计上并不显著（P＞0.05）；X线平片检查出来的骨折块数量显著低于手术探查数量（P＜0.05）。

结论

低剂量CT容积扫描联合三维重建在股骨粗隆间骨折分型中表现出较高的准确性和可靠性，可以作为骨折分型的有效诊断工具，尽管在骨折块数量的检出上与手术探查存在差异，但这种差异无统计学意义，不影响其在临床应用中的价值。

Objective

To evaluate the value of low-dose CT volume scanning combined with 3 D reconstruction in the classification of intertrochanteric fractures.

Methods

Selected 107 patients with intertrochanteric fractures from March 2023 to March 2024， all patients underwent low-dose CT volume scan combined with three-dimensional reconstruction and X-ray plain ray examination， to compare the difference between low-dose CT volume scan， X-ray plain ray exploration and the number of fracture blocks.

Results

The overall accuracy of 87.85%was 84.38%，88.46%，88%，88.24%，10.38%，100.00%，and the Kappa value was 0.867 （P＜0.05）.The overall accuracy of intertrochanteric fracture classification by X-ray diagnosis was 78.50%， for type Ⅰand each stage to type Ⅱ， the accuracy was 75.00%， 76.92%， 80.00%， 82.35% and 85.71%， respectively. The Kappa value was 0.753， significant （P＜0.05）. Although the number of fracture blocks identified by low-dose CT volume scanning combined with 3 D reconstruction was less than that found by surgical exploration，the difference was not statistically significant（P＞0.05）；the number of fracture blocks detected by X-ray plain film was significantly lower than the number of surgical exploration （P＜0.05）.

Conclusion

Low-dose CT volume scanning combined with three-dimensional reconstruction in intertrochanteric fracture classification showed high accuracy and reliability， can be used as a valid diagnostic tool for fracture classification，although in the number of fracture block detection and surgical exploration differences，but the difference is not significant，and does not affect its value in clinical application.