踝关节骨折分型讲述.pptVIP

Test:classify the fracture below 模板来自于 / * lauge-hansen classification and Ottawa ankle rules Author 2015-11-09 Anatomy Medial Collateral Ligament Lateral Collateral Ligament Syndesmotic Ligament soft tissue bone Tibia Fibula Talus ATFL (anterior talofibular) PTFL (posterior talobular) CFL (calcaneo?bular ) AITFL(anterior-inferior tibio?bular ) PITFL(postero-inferior tibio?bular ) transverse tibio?bular ligaments anterior tibiotalar posterior tibiotalar tibionavicular tibiocalcaneal Anatomy Stability The ankle can be thought of as a ring in which bones as well as ligaments play an equally important role in the maintenance of joint stability.If the ring is broken in one place the ring remains stable. When it is broken in two places, the ring is unstable and may dislocate.  lauge-hansen classification In 1950 Lauge-Hansen devised a classification of ankle fractures based on the position of the foot and the deforming force at the time of injury . It consists of four types：SA SER PA PER Supination Adduction ,Supination External Rotation Pronation Abduction ,Pronation External Rotation ROM Pronation 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 Adduction and Abduction 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。 Internal and External exversion 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.Transverse avulsion-type fracture of the fibula below the level of the joint or tear of the lateral collateral ligaments stage2.Vertical fracture of the medial malleolus example1 supination-external rotation（SER） stage1.Disruption of the anterior tibiofibilar ligament stage2.Spiral oblique fracture of the distal fibular stage3.Disruption of the posterior tibiofibilar ligament or fracture of the posterior malleolus stage4.Fracture of the medial malleolus or rupture