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1、踝关节骨折旳Lauge-Hansen分型第1页旋前 旋后第2页内收 外展 外旋AdductionAbductionExteral-rotation第3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扯破。*Verticalfractureofthemedialmalleolus.内踝垂直骨折线。Campbellsoperativeorthopae
2、dics11th第4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*Fractureofthemedialmalleolusorruptureofthedel
3、toidligament内踝骨折或三角韧带扯破第5页Pronation-Abduction(PA)旋前-外展*Transversefractureofthemedialmalleolusorruptureofthedeltoidligament内踝横行骨折或三角韧带扯破*Ruptureofthesyndesmoticligamentsoravulsionfractureoftheirinsertions下胫腓韧带联合扯破或止点骨折*Short,horizontal,obliquefractureofthefibulaabovethelevelofthejoint.高位短斜形或水平腓骨骨折第6页
4、Pronation-Eversion(ExternalRotation)(PER)旋前-外翻（外旋）*Transversefractureofthemedialmalleolusordisruptionofthedeltoidligament内踝横行骨折或三角韧带扯破*Disruptionoftheanteriortibiofibularligament下胫腓前韧带扯破*Shortobliquefractureofthefibulaabovethelevelofthejoint高位腓骨短斜形骨折*Ruptureofposteriortibiofibularligamentoravulsionf
5、ractureoftheposterolateraltibia下胫腓后韧带断裂或后外踝骨折第7页FIGURE53-7SchematicdiagramandcaseexamplesofLauge-Hansensupination-externalrotationandsupination-adductionanklefractures.A.Asupinatedfootsustainseitheranexternalrotationoradductionforceandcreatesthesuccessivestagesofinjuryshowninthediagram.Thesupination
6、-externalrotationmechanismhasfourstagesofinjury,andthesupination-adductionmechanismhastwostages.Anteroposterior(B)andlateral(C)x-raysshowanunstablesupination-externalrotationstageIVanklefracturewiththecharacteristicobliquedistalfibulafractureandamedialsideinjury.D.Ananteroposteriorx-rayofasupination
7、-adductionanklefracturewithatransversefibulafractureandanimpactedmedialmalleolarfracture.第8页FIGURE53-8SchematicdiagramandcaseexamplesofLauge-Hansenpronation-externalrotationandpronation-abductionanklefractures.A.Apronatedfootsustainseitheranexternalrotationorabductionforceandcreatesthesuccessivestag
8、esofinjuryshowninthediagram.Thepronation-externalrotationmechanismhasfourstagesofinjury,andthepronation-abductionmechanismhasthreestages.B.Ananteroposteriorx-rayoftheankleandtibiaandfibulademonstrateahighfibulafracture.C.Externalrotationstressshowslateraldisplacementofthetalusandwideningofthedistals
9、yndesmosis.Thesex-raysarecharacteristicofapronation-externalrotationinjury.D.Ananteroposteriorx-rayofatypicalpronation-abductionanklefracture.Thefibulaislaterallycomminuted.第9页Figure59-22Supination-adductioninjurypathology.Thefirststageislateralfailureofeitherthemalleolusorthecollateralligament.Thes
10、econdstageisaverticalfractureofthemedialmalleolus,whichmaybeassociatedwithmedialplafondimpaction,asshownhere.第10页Figure59-25Supination-externalrotationinjurypathology.Thefirststageisfailureoftheanteriorinferiortibiofibularligament(AITFL).Thesecondstageisaspirallateralmalleolarfractureatthelevelofthe
11、plafond.Thethirdstageisposteriorinferiortibiofibularligament(PITFL)failure.Thefourthstageismedialfailureofeithermalleolusorthedeltoidligament.第11页Figure59-27Pronation-abductioninjurypathology.Thefirststageismedialfailureofeithermalleolusorthedeltoidligament.Thesecondstageissyndesmosis(anteriorinferi
12、ortibiofibularligamentandposteriorinferiortibiofibularligament)disruption.Thethirdstageisabendingfractureofthelateralmalleoluswithatransverse,laterallycomminutedpattern.第12页Figure59-28Pronation-externalrotationinjurypathology.Thefirststageismedialfailureofeithermalleolusorthedeltoidligament.Thesecon
13、dstageisanteriorinferiortibiofibularligamentdisruption.Thethirdstageisaspiralfractureofthefibulaabovetheleveloftheplafond.Thefourthstageisposteriorinferiortibiofibularligamentfailure,demonstratedasaposteriormalleolarfailure.第13页有关网站推荐影像助手：http:/www.radiologyassistant.nl/en/4b6d817d8fade美国足踝外科学会：http:/www.aofas.org/userfiles/file/patiented/ankle/supext1.html第14页