目的 探究儿童胫骨远端三平面 骨折的电子计算机断层扫描(CT)表现及诊 断价值。方法 回顾性分析我院收治的39 例胫骨远端三平面骨折患儿的影像学资 料，所有患儿均行计算机X线成像(CR)正 侧位、螺旋CT平扫加三维重建，比较两种 检查方式对骨折分型的诊断价值。结果 根据胫骨远端骨骺损伤位置，所有患儿均 为外侧型；根据骨折块数目，二部分型24 例，三部分型15例，无四部分型；根据骨 折线是否累及关节面，I型22例，II型15 例，III型2例；CR将12例三部分型诊断为 二部分型，15例对关节面位置误诊或不能 诊断分型；6例误诊为Salter-HarrisIII 型；CT扫描对所有分型均诊断准确；随访 观察无成角畸形发生。结论 螺旋CT平扫 结合三维重建对胫骨远端三平面骨折有较 高的诊断价值，临床上可将其与CR结合为 临床提供有价值的信息。

Objective To explore the imaging findings and diagnostic value of computerized tomography (CT) for children with distal tibial tri-plane fractures. Methods The imaging data of 39 children with distal tibial tri-plane fractures treated in the hospital were analyzed retrospectively. All children underwent computerized radiograph (CR) positive and lateral position, spiral CT plain scan and three-dimensional reconstruction. The diagnostic value of the two examination methods for classification of fractures was compared. Results According to the location of distal tibial epiphyseal injury, all children were lateral type. According to the number of fractures, 24 cases were two-part type and 15 cases were three-part type, without four-part type. According to the condition of fracture line involving the articular surface, 22 cases were type I, 15 cases were type II and 2 cases were type III. There were 12 cases of three-part type diagnosed as two-part type by CR. The location of articular surface in 15 cases was misdiagnosed or can not be diagnosed. 6 cases were misdiagnosed as Salter-Harris type III. All types displayed by CT scan were accurate and no angulation deformity was observed during follow-up. Conclusion Spiral CT plain scan combined with three-dimensional reconstruction is of high diagnostic value for distal tibial tri-plane fractures. Clinically, it can be combined with CR to provide valuable information.