踝关节骨折的分型精选课件.ppt

关于踝关节骨折的分型第一页，本课件共有14页旋前 旋后第二页，本课件共有14页内收 外展 外旋AdductionAbductionExteral-rotation第三页，本课件共有14页Supination-Adduction(SA)旋后-内收*Transverseavulsion-typefractureofthefibulabelowthelevelofthejointortearofthelateralcollateralligaments.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。Campbellsoperativeorthopaedics11th第四页，本课件共有14页Supination-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第五页，本课件共有14页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第六页，本课件共有14页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第七页，本课件共有14页FIGURE53-7SchematicdiagramandcaseexamplesofLauge-Hansensupination-externalrotationandsupination-adductionanklefractures.A.Asupinatedfootsustainseitheranexternalrotationoradductionforceandcreatesthesuccessivestagesofinjuryshowninthediagram.Thesupination-externalrotationmechanismhasfourstagesofinjury,andthesupination-adductionmechanismhastwostages.Anteroposterior(B)andlateral(C)x-raysshowanunstablesupination-externalrotationstageIVanklefracturewiththecharacteristicobliquedistalfibulafractureandamedialsideinjury.D.Ananteroposteriorx-rayofasupination-adductionanklefracturewithatransversefibulafractureandanimpactedmedialmalleolarfracture.第八页，本课件共有14页FIGURE53-8SchematicdiagramandcaseexamplesofLauge-Hansenpronation-externalrotationandpronation-abductionanklefractures.A.Apronatedfootsustainseitheranexternalrotationorabductionforceandcreatesthesuccessivestagesofinjuryshowninthediagram.Thepronation-externalrotationmechanismhasfourstagesofinjury,andthepronation-abductionmechanismhasthreestages.B.Ananteroposteriorx-rayoftheankleandtibiaandfibulademonstrateahighfibulafracture.C.Externalrotationstressshowslateraldisplacementofthetalusandwideningofthedistalsyndesmosis.Thesex-raysarecharacteristicofapronation-externalrotationinjury.D.Ananteroposteriorx-rayofatypicalpronation-abductionanklefracture.Thefibulaislaterallycomminuted.第九页，本课件共有14页Figure59-22Supination-adductioninjurypathology.Thefirststageislateralfailureofeitherthemalleolusorthecollateralligament.Thesecondstageisaverticalfractureofthemedialmalleolus,whichmaybeassociatedwithmedialplafondimpaction,asshownhere.第十页，本课件共有14页Figure59-25Supination-externalrotationinjurypathology.Thefirststageisfailureoftheanteriorinferiortibiofibularligament(AITFL).Thesecondstageisaspirallateralmalleolarfractureattheleveloftheplafond.Thethirdstageisposteriorinferiortibiofibularligament(PITFL)failure.Thefourthstageismedialfailureofeithermalleolusorthedeltoidligament.第十一页，本课件共有14页Figure59-27Pronation-abductioninjurypathology.Thefirststageismedialfailureofeithermalleolusorthedeltoidligament.Thesecondstageissyndesmosis(anteriorinferiortibiofibularligamentandposteriorinferiortibiofibularligament)disruption.Thethirdstageisabendingfractureofthelateralmalleoluswithatransverse,laterallycomminutedpattern.第十二页，本课件共有14页Figure59-28Pronation-externalrotationinjurypathology.Thefirststageismedialfailureofeithermalleolusorthedeltoidligament.Thesecondstageisanteriorinferiortibiofibularligamentdisruption.Thethirdstageisaspiralfractureofthefibulaabovetheleveloftheplafond.Thefourthstageisposteriorinferiortibiofibularligamentfailure,demonstratedasaposteriormalleolarfailure.第十三页，本课件共有14页09.12.2022感感谢谢大大家家观观看看第十四页，本课件共有14页