医疗护理医学培训 踝关节骨折的Lauge-Hansen分型课件

踝关节骨折的Lauge-Hansen分型旋前旋后内收外展外旋AdductionAbductionExteral-rotationSupination-Adduction(SA)

旋后-内收

*Transverseavulsion-typefractureofthe

fibulabelowthelevelofthejointortear

ofthelateralcollateralligaments

.

腓骨下端横行撕脱骨折或外侧副韧带撕裂。

*Verticalfractureofthemedialmalleolus.

内踝垂直骨折线。Campbell'soperativeorthopaedics11thSupination-Eversion(External-Rotation)(SER)旋后-外翻（外旋）*Disruptionoftheanteriortibiofibularligament

下胫腓前韧带断裂

*Spiralobliquefractureofthedistalfibula

腓骨远端螺旋型骨折*Disruptionoftheposteriortibiofibularligamentorfractureoftheposteriormalleolus

下胫腓后韧带断裂或后踝骨折*Fractureofthemedialmalleolusorruptureofthedeltoidligament

内踝骨折或三角韧带撕裂Pronation-Abduction(PA)旋前-外展*Transversefractureofthemedialmalleolusorruptureofthedeltoidligament

内踝横行骨折或三角韧带撕裂*Ruptureofthesyndesmoticligamentsoravulsionfractureoftheirinsertions

下胫腓韧带联合撕裂或止点骨折*Short,horizontal,obliquefractureofthefibulaabovethelevelofthejoint.

高位短斜形或水平腓骨骨折Pronation-Eversion(ExternalRotation)(PER)旋前-外翻（外旋）

*Transversefractureofthemedialmalleolusordisruptionofthedeltoidligament

内踝横行骨折或三角韧带撕裂*Disruptionoftheanteriortibiofibularligament

下胫腓前韧带撕裂

*Shortobliquefractureofthefibulaabovethelevelofthejoint

高位腓骨短斜形骨折*Ruptureofposteriortibiofibularligamentoravulsionfractureoftheposterolateraltibia下胫腓后韧带断裂或后外踝骨折FIGURE53-7SchematicdiagramandcaseexamplesofLauge-Hansensupination-externalrotationandsupination-adductionanklefractures.A.Asupinatedfootsustainseitheranexternalrotationoradductionforceandcreatesthesuccessivestagesofinjuryshowninthediagram.Thesupination-externalrotationmechanismhasfourstagesofinjury,andthesupination-adductionmechanismhastwostages.Anteroposterior(B)andlateral(C)x-raysshowanunstablesupination-externalrotationstageIVanklefracturewiththecharacteristicobliquedistalfibulafractureandamedialsideinjury.D.Ananteroposteriorx-rayofasupination-adductionanklefracturewithatransversefibulafractureandanimpactedmedialmalleolarfracture.FIGURE53-8SchematicdiagramandcaseexamplesofLauge-Hansenpronation-externalrotationandpronation-abductionanklefractures.A.Apronatedfootsustainseitheranexternalrotationorabductionforceandcreatesthesuccessivestagesofinjuryshowninthediagram.Thepronation-externalrotationmechanismhasfourstagesofinjury,andthepronation-abductionmechanismhasthreestages.B.Ananteroposteriorx-rayoftheankleandtibiaandfibulademonstrateahighfibulafracture.C.Externalrotationstressshowslateraldisplacementofthetalusandwideningofthedistalsyndesmosis.Thesex-raysarecharacteristicofapronation-externalrotationinjury.D.Ananteroposteriorx-rayofatypicalpronation-abductionanklefracture.Thefibulaislaterallycomminuted.Figure59-22

Supination-adductioninjurypathology.Thefirststageislateralfailureofeitherthemalleolusorthecollateralligament.Thesecondstageisaverticalfractureofthemedialmalleolus,whichmay

beassociatedwithmedialplafondimpaction,asshownhere.

Figure59-25Supination-externalrotationinjurypathology.Thefirststageisfailureoftheanteriorinferiortibiofibularligament(AITFL).Thesecondstageisaspirallateralmalleolarfractureattheleveloftheplafond.Thethirdstageisposteriorinferiortibiofibularligament(PITFL)failure.Thefourthstageismedialfailureofeithermalleolusorthedeltoidligament.Figure59-25Supination-externalrotationinjurypathology.Thefirststageisfailureoftheanteriorinferiortibiofibularligament(AITFL).Thesecondstageisaspirallateralmalleolarfractureattheleveloftheplafond.Thethirdstageisposteriorinferiortibiofibularligament(PITFL)failure.Thefourthstageismedialfailureofeithermalleolusorthedeltoidligament.Figure59-27Pronation-abductioninjurypathology.Thefirststageismedialfailureofeithermalleolusorthedeltoidligament.Thesecondstageissyndesmosis(anteriorinferiortibiofibularligamentandposteriorinferiortibiofibularligament)disruption.Thethirdstageisabendingfractureofthelateralmalleoluswithatransverse,laterallycomminutedpattern.Figure59-28Pronation-externalrotationinjurypathology.Thefirststageismedialfailureofeithermalleolusorthedeltoidligament.Thesecondstageisanteriorinferiortibiofibularligamentdisruption.Thethirdstageisaspiralfractureofthefibulaabovetheleveloftheplafond.Thefourthstageisposteriorinferiortibiofibularligamentfailure,demonstratedasaposteriormalleolarfailure.备用工具&资料Figure59-27Pronation-abductioninjurypathology.Thefirststageismedialfailureofeithermalleolusorthedeltoidligament.Thesecondstageissyndesmosis(anteriorinferiortibiofibularligamentandposteriorinferiortibiofibularligament)disruption.Thethirdstageisabendingfractureofthelateralmalleoluswithatransverse,laterallycomminutedpattern.Figure59-22

Supination-adductioninjurypathology.Thefirststageislateralfailureofeitherthemalleolusorthecollateralligament.Thesecondstageisaverticalfractureofthemedialmalleolus,whichmay

beassociatedwithmedialplafondimpaction,asshownhere.

Figure59-22

Supination-adductioninjurypathology.Thefirststageislateralfailureofeitherthemalleolusorthecollateralligament.Thesecondstageisaverticalfractureofthemedialmalleolus,whichmay

beassociatedwithmedialplafondimpaction,asshownhere.

内收外展外旋AdductionAbductionExteral-rotationSupination-Eversion(External-Rotation)(SER)旋后-外翻（外旋）*Disruptionoftheanteriortibiofibularligament

下胫腓前韧带断裂

*Spiralobliquefractureofthedistalfibula

腓骨远端螺旋型骨折*Disruptionoftheposteriortibiofibularligamentorfractureoftheposteriormalleolus

下胫腓后韧带断裂或后踝骨折*Fractureofthemedialmalleolusorruptureofthedeltoidligament

内踝骨折或三角韧带撕裂