踝部的骨折与损伤.docVIP

Whats New in Foot and Ankle SurgeryIntroductionThis update summarizes recent research pertaining to foot and ankle surgery that was published or presented between August 2008 and July 2009. The sources of these studies include The Journal of Bone and Joint Surgery (American and British Volumes); Foot and Ankle International; the proceedings of Specialty Day at the Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), held on February 28, 2009, in Las Vegas, Nevada; and the summer meeting of the American Orthopaedic Foot and Ankle Society (AOFAS), held on July 15 through 18, 2008, in Vancouver, British Columbia, Canada. 引言这些有关足踝外科更新文献来自于2008年8月到2009年7月其间发表的或公开的，来源包括JBJS杂志（美国版和英国版）、国际足踝杂志、2009年2月28日在Nevada Las Vegas的美国矫形外科医师学会上的记录、2008年7月15号到18号华美国矫形外科足踝协会（AOFAS)在加拿大的不列颠哥仑比亚省的温哥华举行的夏季年会。Ankle Fractures and Trauma 踝部的骨折与损伤Since its inception, the Lauge-Hansen ankle fracture classification system has commonly been utilized by the orthopaedic community to correlate the mechanism of injury with the radiographic fracture pattern. Despite its enduring clinical use, the Lauge-Hansen classification system is often confusing and cumbersome and has lacked experimental reproducibility. Numerous investigators have been unable to specifically recreate the stage-4 supination-external rotation fracture pattern in an experimental setting. The lack of reproducibility has caused investigators to challenge the dogma that an external rotation force produces a fibular fracture pattern oriented from anteroinferior to posterosuperior only with the foot in a supinated position. Haraguchi and Armiger used a biomechanical cadaver model to prove their hypothesis that a pronated foot could produce fracture patterns traditionally ascribed to a supination-external rotation mechanism1. According to the authors, the pattern of fibular fracture would largely be determined by the amount of laterally directed force (an abduction moment) applied to the foot in pronation. Fiftee