目的分析X线与螺旋CT三维重 建技术在踝关节骨折Lauge-Hansen分型 诊断中的应用价值。方法 选取2016年12 月-2017年12月我院收治的96例踝关节骨 折患者纳入研究，术前均接受X线与螺旋 CT三维重建检查，以术中探查与MRI检查 结果为金标准，比较分析X线与螺旋CT三 维重建技术对踝关节骨折Lauge-Hansen分 型诊断准确性。结果 术中探查与术前MRI 诊断显示45例下胫腓联合损伤，X线诊断 下胫腓联合损伤正确率为62.22%，明显低 于螺旋CT正确率88.89%(P＜0.05)；螺旋 CT对Lauge-Hansen分型灵敏度、特异度、 准确性、Kappa值均高于X线。结论 与X线 相比，螺旋CT三维重建技术在踝关节骨折 Lauge-Hansen分型诊断中具有更大优势， 具有较高准确性，X线能对大多数踝关节 骨折提供基本分型依据，如若X线检查结 果有疑问或下胫腓联合损伤，则需结合CT 检查。

Objective To analyze the application value of X - ray and spiral CT 3D reconstruction in Lauge-Hansen classification diagnosis of ankle fracture. Methods 96 patients with ankle fractures who were admitted to the hospital from December 2016 to December 2017 were included in the study. All patients were examined by X-ray and spiral CT 3D reconstruction before operation. With results of intraoperative exploration and MRI examination as the golden standard, the accuracy in Lauge-Hansen classification diagnosis of ankle fracture was compared between X-ray and spiral CT 3D reconstruction. Results 45 cases of distal tibiofibular combined injuries were diagnosed by intraoperative exploration and preoperative MRI. The accuracy rate of X-ray diagnosis of distal tibiofibular combined injuries was significantly lower than that of spiral CT (62.22% vs 88.89%) (P<0.05). The sensitivity, specificity, accuracy and Kappa value of spiral CT for Lauge-Hansen classification were higher than those of X-ray. Conclusion Compared with X-ray, spiral CT 3D reconstruction has more advantages in Lauge-Hansen classification diagnosis of ankle fracture, and the accuracy is higher. X-ray can provide the basis for basic classification of most ankle fracture types. If X-ray examination shows questions or distal tibiofibular combined injuries, CT examination is needed.