踝关节骨折的LaugeHansen分型.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,*,本文档所提供的信息仅供参考之用，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。,旋前 旋后,内收 外展 外旋,Adduction Abduction Exteral-rotation,Supination-Adduction(SA)旋后-内收*,Transverse avulsion-type fracture of the fibula below the level of the joint or tear of the lateral collateral ligaments.,腓骨下端横行撕脱骨折或外侧副韧带撕裂。,*Vertical fracture of the medial malleolus.,内踝垂直骨折线。,Campbells operative orthopaedics 11th,Supination-Eversion(External-Rotation)(SER),旋后-外翻（外旋）,*Disruption of the anterior tibiofibular ligament,下胫腓前韧带断裂,*Spiral oblique fracture of the distal fibula,腓骨远端螺旋型骨折,*Disruption of the posterior tibiofibular ligament or,fracture of the posterior malleolus,下胫腓后韧带断裂或后踝骨折,*Fracture of the medial malleolus or rupture of the,deltoid ligament,内踝骨折或三角韧带撕裂,Pronation-Abduction(PA),旋前-外展,*Transverse fracture of the medial,malleolus or rupture of the deltoid ligament,内踝横行骨折或三角韧带撕裂,*Rupture of the syndesmotic ligaments or,avulsion fracture of their insertions,下胫腓韧带联合撕裂或止点骨折,*Short,horizontal,oblique fracture of the,fibula above the level of the joint.,高位短斜形或水平腓骨骨折,Pronation-Eversion(External Rotation)(PER),旋前-外翻（外旋）,*,Transverse fracture of the medial malleolus or,disruption of the deltoid ligament,内踝横行骨折或三角韧带撕裂,*Disruption of the anterior tibiofibular ligament,下胫腓前韧带撕裂,*Short oblique fracture of the fibula above the,level of the joint,高位腓骨短斜形骨折,*Rupture of posterior tibiofibular ligament or,avulsion fracture of the posterolateral tibia,下胫腓后韧带断裂或后外踝骨折,FIGURE 53-7 Schematic diagram and case examples of Lauge-Hansen supination-external rotation and supination-adduction ankle fractures.A.A supinated foot sustains either an external rotation or adduction force and creates the successive stages of injury shown in the diagram.The supination-external rotation mechanism has four stages of injury,and the supination-adduction mechanism has two stages.Anteroposterior(B)and lateral(C)x-rays show an unstable supination-external rotation stage IV ankle fracture with the characteristic oblique distal fibula fracture and a medial side injury.D.An anteroposterior x-ray of a supination-adduction ankle fracture with a transverse fibula fracture and an impacted medial malleolar fracture.,FIGURE 53-8 Schematic diagram and case examples of Lauge-Hansen pronation-external rotation and pronation-abduction ankle fractures.A.A pronated foot sustains either an external rotation or abduction force and creates the successive stages of injury shown in the diagram.The pronation-external rotation mechanism has four stages of injury,and the pronation-abduction mechanism has three stages.B.An anteroposterior x-ray of the ankle and tibia and fibula demonstrate a high fibula fracture.C.External rotation stress shows lateral displacement of the talus and widening of the distal syndesmosis.These x-rays are characteristic of a pronation-external rotation injury.D.An anteroposterior x-ray of a typical pronation-abduction ankle fracture.The fibula is laterally comminuted.,Figure 59-22,Supination-adduction injury pathology.The first stage is lateral failure of either the malleolus or the collateral ligament.The second stage is a vertical fracture of the medial malleolus,which maybe associated with medial plafond impaction,as shown here.,Figure 59-25,Supination-external rotation injury pathology.The first stage is failure of the anterior inferior tibiofibular ligament(AITFL).The second stage is a spiral lateral malleolar fracture at the level of the plafond.The third stage is posterior inferior tibiofibular ligament(PITFL)failure.The fourth stage is medial failure of either malleolus or the deltoid ligament.,Figure 59-27,Pronation-abduction injury pathology.The first stage is medial failure of either malleolus or the deltoid ligament.The second stage is syndesmosis(anterior inferior tibiofibular ligament and posterior inferior tibiofibular ligament)disruption.The third stage is a bending fracture of the lateral malleolus with a transverse,laterally comminuted pattern.,Figure 59-28,Pronation-external rotation injury pathology.The first stage is medial failure of either malleolus or the deltoid ligament.The second stage is anterior inferior tibiofibular ligament disruption.The third stage is a spiral fracture of the fibula above the level of the plafond.The fourth stage is posterior inferior tibiofibular ligament failure,demonstrated as a posterior malleolar failure.,相关网站推荐,影像助手：,www.radiologyassistant.nl/en/4b6d817d8fade,美国足踝外科学会：,www.aofas.org/userfiles/file/patiented/ankle/supext1.html,