骨科踝关节手术.pptxVIP

骨科踝关节手术第1页/共69页 ANKLE FRACTURESNetbasert undervisning april 0501Illustrations redrawn from Malleolar Fractures and Soft Tissue Injuries of the ankle: Carr JBAnkle fractures: Marsch JL, Salzman CLComposition: Bengt ?stman overlege Presentation: Simen Sellevold, assistentlege Ingo Spauke, assistentlege第2页/共69页 Epidemiology02Incidence: 80–130 per 100 000 persons highest in elderly women 67% isolated malleolar fractures 25% bimalleolar 8% trimalleolar ANKLE FRACTURESNational Hospital Discharge Register of Finland 1994Court-BrownCM, McBirnie J, Wilson G. Adult ankle fractures: an increasing problem? Acta Orthop Scand 1998;69:43-47第3页/共69页 03Incidence: Ringerike Hospital 1/8 2003 – 31/7 2004: 184 per 70 000 - 100 000 persons 128/184 (69%) isolated malleolar fractures 27/184 (15%) bimalleolar 29/184 (16%) trimalleolar ANKLE FRACTURESEpidemiology第4页/共69页 04ANKLE FRACTURESClassification - Why?Why do we require fracture classifications? for clinical research to understand the literature as an aid to fracture description as an aid to fracture treatment第5页/共69页 05AO (Danis/Weber)Type A below the syndesmosisType B at the level of the syndesmosisType C above the syndesmosisDanis R. Les fractures malleolaires. In: Danis R, ed. Théorie et practique de l`osteosynthése. 1949:133-165.Weber BG. Die Verletzungen des oberen Sprunggelenkes, Berne: Hans Huber, 1966. (2nd ed. 1972)Classification – AO (Danis/Weber)ANKLE FRACTURES第6页/共69页 06AO AO/OTA (Weber)3 types (A, B, C) 9 groups (A1, A2, A3, B1, B2, B3, C1, C2, C3) 27 subgroupsMüller ME, Allg?wer M, Schneider R, et al.. Manual of internal fixation, 2nd ed. Heidelberg: Springer-Verlag, 1979:282-299. (3rd ed. 1991).Orthopaedic Trauma Assocoation. Fracture and dislocation compendium. J Orthop Trauma 1996;10:1-55.Classification – AO/OTAANKLE FRACTURES第7页/共69页 07AO AO/OTA Lauge-HansenLauge-H