踝关节骨折分型

supination-adduction（SA）
stage1.Transverse avulsion-type fracture of the fibula below the level of the joint or tear of the lateral collateral ligaments
example2
pronation-external rotation（PER）
stage1.Transverse fracture of the medial malleolus or disruption of the deltoid ligament
stage2.Disruption of the anterior tibiofibular ligament
anterior tibiotalar posterior tibiotalar tibionavicular tibiocalcaneal
AnatFra Baidu bibliotekmy
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.
外展：脚掌朝向外侧， 内收：脚掌朝向内侧， 距骨上关节面转向内。 距骨上关节面转向外。
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。
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 of the deltoid ligament
Medial Collateral Ligament
ATFL (anterior talofibular) PTFL (posterior talobular)
CFL (calcaneofibular )
AITFL(anterior-inferior tibiofibular ) PITFL(postero-inferior tibiofibular ) transverse tibiofibular ligaments
example3
pronation-abduction（PA）
stage1.transverse fracture of the medial malleolus or rupture of the deltoid ligament
stage2.Rupture of the syndesmotic ligaments or avulsion fracture of their insertion
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
lauge-hansen classification and Ottawa ankle rules
Author 2015-11-09
Anatomy
bone
Tibia Fibula Talus
soft tissue
Lateral Collateral Ligament
Syndesmotic Ligament
stage3.Short oblique fracture of the fibular above the level of the joint
stage4.Rupture of posterior tibiofibular ligament or avulsion fracture of the posterolateral tibia
stage3.Short,horizontal,oblique fracture of the fibular above the level of the joint
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
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。