背景:对数分裂器损伤是一种高能量踝关节骨折脱位。损伤的机制尚未详细描述。对放射学特征和病理变化的详细了解可以进一步指导治疗。
方法:2009年4月至2018年12月,对62例Logsplitter损伤患者进行回顾性分析。这项研究分析了腓骨损伤的特点,胫骨损伤,联合韧带损伤,术前X线和CT扫描的内侧损伤和外侧韧带损伤。总结了不同损伤类型的发生率。使用踝关节骨折的Lauge-Hansen分类法分析了Logsplitter损伤与引起它们的机制之间的相关性。
结果:该研究提供了观察到的骨折类型的数据。在全部骨折中,98.4%为开放性骨折。腓骨损伤分类为无骨折(1.6%),横向或短斜形骨折(61.3%),蝴蝶碎片(25.8%),粉碎性骨折(11.3%)。胫骨损伤包括外侧关节面受压(38.7%)和后部受压(6.5%)。中伤,包括内踝骨折,占87.1%,三角肌韧带断裂占12.9%。研究发现,韧带联合损伤包括简单的韧带破裂(11.3%),Tillaux骨折(8.1%),Volkmann骨折(43.5%),Tillaux和Volkmann骨折(37.1%)。在12.9%的案例中,外侧副韧带完全断裂.基于Lauge-Hansen分类,87.1%的损伤是内旋-外展损伤,而8.1%是内旋和外旋损伤,1.6%为旋后外旋伤。此外,3.2%的病例无法分类。
结论:对数分裂损伤的病理解剖特征多样,部分病例伴有副韧带损伤。必须指出,这些评价是客观的,并基于当前的结果。最常见的伤害机制是垂直暴力与绑架相结合,虽然在某些情况下,它可能是垂直组合的外部旋转损伤。
方法:(4)案例系列。
背景:本研究已获西安交通大学红会医院伦理研究委员会批准,代码下:202,003,002。
BACKGROUND: Logsplitter Injury is a type of high-energy ankle fracture dislocation. The mechanism of injury has not been described in detail. A detailed understanding of the radiological features and pathological changes can further guide treatment.
METHODS: Between April 2009 and December 2018, a retrospective analysis was conducted on 62 patients with Logsplitter injury. The study analysed the characteristics of fibular injury, tibial injury, syndesmosis injury, medial injury and lateral ligament injury on preoperative X-ray and CT scans. The incidence of the different injury types was summarised. The correlation between Logsplitter injuries and the mechanisms causing them were analysed using the Lauge-Hansen classification of ankle fractures.
RESULTS: The study provides data on the types of fractures observed. Of the total fractures, 98.4% were open fractures. The fibula injuries were classified as no fracture (1.6%), transverse or short oblique fractures (61.3%), butterfly fragments (25.8%), and comminuted fractures (11.3%). The tibial injuries included compression of lateral articular surfaces (38.7%) and posterior compressions (6.5%). Medial injuries, including medial malleolar fractures, accounted for 87.1%, and deltoid ligament rupture accounted for 12.9%. The study found that injuries to the syndesmosis consisted of simple ligament ruptures (11.3%), Tillaux fractures (8.1%), Volkmann fractures (43.5%), and Tillaux and Volkmann fractures (37.1%). In 12.9% of cases, there was a complete rupture of the lateral collateral ligament. Based on the Lauge-Hansen classification, 87.1% of injuries were pronation-abduction injuries, while 8.1% were pronation and external rotation injuries, and 1.6% were supination external rotation injuries. Furthermore, 3.2% of cases could not be classified.
CONCLUSIONS: The pathoanatomic characteristics of Logsplitter injury are diverse, with some cases accompanied by collateral ligament injury. It is important to note that these evaluations are objective and based on current results. The most common injury mechanism is vertical violence combined with abduction, although in some cases, it may be a vertical combined external-rotation injury.
METHODS: (4) case series.
BACKGROUND: This study has been approved by the ethical research committee of the Honghui Hospital of Xi\'an Jiaotong University, under the code: 202,003,002.