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1、踝关节骨折的Lauge-Hansen分型,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。,Cam
2、pbells 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
3、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
4、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 lig
5、ament 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 sup
6、ination-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
7、. 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 a
8、nd 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
9、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
10、 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
11、 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
12、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
13、-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 lat
14、eral 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 spira
15、l 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： http:/www.radiologyassistant.nl/en/4b6d817d8fade 美国足踝外科学会： http:/www.aofas.org/userfiles/file/patiented/ankle/supext1.html,