三踝骨折的独立分型
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作者Author单位AddressE-Mail
成永忠 CHENG Yong-zhong 中国中医研究院骨伤科研究所创二科,北京100700 Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine,Beijing,100700,China bless518@yahoo.com.cn 
温建民 WEN Jian-min 中国中医研究院骨伤科研究所创二科,北京100700 Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine,Beijing,100700,China  
马少云 MA Shao-yun 广东省中医院珠海医院  
桑志成 SANG Zhi-cheng 中国中医研究院骨伤科研究所创二科,北京100700 Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine,Beijing,100700,China  
赵勇 ZHAO Yong 中国中医研究院骨伤科研究所创二科,北京100700 Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine,Beijing,100700,China  
徐颖鹏 XU Ying-peng 中国中医研究院骨伤科研究所创二科,北京100700 Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine,Beijing,100700,China  
蒋科卫 JIANG Ke-wei 中国中医研究院骨伤科研究所创二科,北京100700 Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine,Beijing,100700,China  
张崇辉 ZHANG Chong-hui 中国中医研究院骨伤科研究所创二科,北京100700 Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine,Beijing,100700,China  
王雷 WANG Lei 中国中医研究院骨伤科研究所创二科,北京100700 Institute of Orthopaedics and Traumatology,China Academy of Traditional Chinese Medicine,Beijing,100700,China  
期刊信息:《中国骨伤》2005年,第18卷,第8期,第483-486页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:探讨并总结与三踝骨折的独特移位规律相对应的独立分型,改进其复位与固定方法。

方法:根据42例三踝骨折患者的术前X线片,根据其有无距骨移位和移位方向以及有无下胫腓分离进行分型,并与传统分型进行比较。

结果:三踝骨折可分为稳定型(12例)和非稳定型(30例)。非稳定型又分为3型:Ⅰ型(距骨外脱位型)16例,其中,Ⅰa型(无下胫腓分离的距骨外脱位型)5例;Ⅰb型(有下胫腓分离的距骨外脱位型)11例;Ⅱ型(距骨外后脱位型)8例,其中,Ⅱb型(无下胫腓分离的外后脱位型)5例,Ⅱb型(有下胫腓分离的外后脱位型)3例;Ⅲ型(距骨后脱位型)6例,其中,Ⅲa型(无下胫腓分离的后脱位型)2例,Ⅲb型(有下胫腓分离的后脱位型)4例。

结论:根据X线片可对三踝骨折进行独立分型。三踝骨折的独立分型突出了距骨脱位和下胫腓分离两个反映踝关节损伤程度的重要因素,深化了对三踝骨折移位规律的认识,并对其手术适应证的选择、预后判断、手术顺序的安排等均有一定指导意义。
【关键词】三踝骨折  分类法  距骨脱位  下胫腓分离
 
An independent classification of trimalleolar fractures
ABSTRACT  

Objective: To investigate an independent classification of trimalleolar fractures according to unique dislocation regularity and to improve the reduction and fixation.

Methods:The preoperative radiographs in 42 cases of trimalleolar fractures were studied,and a classification of trimalleolar fractures was concluded according to dislocation of talus and diastasis of distal tibiofibular syndesmosis.The classification of trimalleolar fractures was compared with the traditional classification.

Results:Trimalleolar fracture was classified into stable (12 cases) and unstable (30 cases) types.The unstable types was divided into three sub-types:TypeⅠ (lateral dislocation of talus)in 16 cases,typeⅡ (lateral-posterior dislocation of talus)in 8 cases and typeⅢ (posterior dislocation of talus) in 6 cases.TypeⅠ included typeⅠa (without diastasis of distal tibiofibular syndesmosis)in 5 cases and typeⅠb(diastasis of distal tibiofibular syndesmosis)in 11 cases.TypeⅡ included typeⅡa(without diastasis of distal tibiofibular syndesmosis)in 5 cases and typeⅡb (diastasis of distal tibiofibular syndesmosis)in 3 cases.TypeⅢ included typeⅢa(without diastasis of distal tibiofibular syndesmosis)in 2 cases and typeⅢb(diastasis of distal tibiofibular syndesmosis)in 4 cases.

Conclusion:The independent classification of trimalleolar fractures can be made according to X-ray film.The independent classification of trimalleolar fractures emphasizes two important factors of ankle joint injuries:talus dislocation and distal tibiofibular syndesmosis diastasis.It can facilitate the better understanding of dislocation regularity of trimalleolar fractures and is conducive to selection of indication,prognostic judgement and arrangement of operative order.
KEY WORDS  Trimalleolar fractures  Classification  Talus dislocation  Distal tibiofibular diastasis
 
引用本文,请按以下格式著录参考文献:
中文格式:成永忠,温建民,马少云,桑志成,赵勇,徐颖鹏,蒋科卫,张崇辉,王雷.三踝骨折的独立分型[J].中国骨伤,2005,18(8):483~486
英文格式:CHENG Yong-zhong,WEN Jian-min,MA Shao-yun,SANG Zhi-cheng,ZHAO Yong,XU Ying-peng,JIANG Ke-wei,ZHANG Chong-hui,WANG Lei.An independent classification of trimalleolar fractures[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(8):483~486
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