踝关节骨折的分型周勇VIP免费

踝关节骨折的分型成都市双流区中医医院骨科周勇主治医师跟腓韧带胫舟韧带胫距后韧带下胫腓横韧带Stability§Theanklecanbethoughtofasaringinwhichbonesaswellasligamentsplayanequallyimportantroleinthemaintenanceofjointstability.§Iftheringisbrokeninoneplacetheringremainsstable.Whenitisbrokenintwoplaces,theringisunstableandmaydislocate.Danis-WeberClassificationAOClassificationlauge-hansenclassification踝关节骨折的分型单踝、双踝、三踝Danis-WeberClassificationTheWebersystemowesitspopularitymainlytoitssimplicity.TypeAoccursbelowthesyndesmosis,whichisintact.TypeBisatranssyndesmoticfracturewithusuallypartialandlesscommonly,totalruptureofthesyndesmosis.TypeCoccursabovethelevelofthesyndesmosiswithusuallyatotalruptureofthesyndesmosis,andconsequentlyinstabilityoftheanklemortise.AOClassificationA型：韧带联合平面以下腓骨骨折（韧带联合下型）A1单纯外踝骨折；A2合并内踝损伤；A3合并后内侧骨折AOClassificationB型：韧带联合平面腓骨骨折（经韧带联合型）B1单纯腓骨骨折；B2合并内侧损伤；B3合并内侧损伤及胫骨后外侧骨折AOClassificationC型：韧带联合平面以上腓骨骨折（韧带联合上型）C1单纯腓骨骨干骨折；C2复合性腓骨干骨折；C3近端腓骨骨折lauge-hansenclassificationIn1950Lauge-Hansendevisedaclassificationofanklefracturesbasedonthepositionofthefootandthedeformingforceatthetimeofinjury.Itconsistsoffourtypes：SASERPAPERSupinationAdduction,SupinationExternalRotationPronationAbduction,PronationExternalRotationROMPronation旋前是背伸、外翻、外展的组合动作，旋前时足外侧缘抬高，内侧缘降低，跖朝向外侧Supination旋后是跖屈、内翻、内收的组合动作，旋后时足内侧缘抬高，外侧缘降低，跖朝向内侧AdductionandAbduction外展：脚掌朝向外侧，距骨上关节面转向内。内收：脚掌朝向内侧，距骨上关节面转向外。这里所说的内收外展，是指暴力的方向。而暴力的方向都是针对距骨而言的，距骨围绕自身前后长轴的旋转运动。InternalandExternalexversion同理，内、外旋指距骨相对胫骨的运动，是距骨发生在水平方向的活动，距骨头向内称为内旋，距骨头向外称为外旋。lauge-hansen分型中只有外旋，无内旋。supination-adduction（SA）stage1.Transverseavulsion-typefractureofthefibulabelowthelevelofthejointortearofthelateralcollateralligamentsstage2.Verticalfractureofthemedialmalleolusexample1supination-externalrotation（SER）stage1.Disruptionoftheanteriortibiofibilarligamentstage2.Spiralobliquefractureofthedistalfibularstage2.Spiralobliquefractureofthedistalfibularexample2supination-externalrotation（SER）stage3.Disruptionoftheposteriortibiofibilarligamentorfractureoftheposteriormalleolusstage4.Fractureofthemedialmalleolusorruptureofthedeltoidligamentpronation-abduction（PA）stage1.transversefractureofthemedialmalleolusorruptureofthedeltoidligamentstage2.Ruptureofthesyndesmoticligamentsoravulsionfractureoftheirinsertionpronation-abduction（PA）stage3.Short,horizontal,obliquefractureofthefibularabovethelevelofthejointexample3pronation-externalrotation（PER）stage1.Transversefractureofthemedialmalleolusordisruptionofthedeltoidligamentstage2.Disruptionoftheanteriortibiofibularligamentpronation-externalrotation（PER）stage3.Shortobliquefractureofthefibularabovethelevelofthejointpronation-externalrotation（PER）stage4.Ruptureofposteriortibiofibularligamentoravulsionfractureoftheposterolateraltibiaexample4supination-adductionSAsupination-externalrotationSERpronation-abductionPApronation-externalrotationPERSeeyounexttime胫骨Pilon骨折Thankyou！