骨科--踝关节手术.ppt

ANKLEFRACTURESNetbasertundervisningapril0501IllustrationsredrawnfromMalleolarFracturesandSoftTissueInjuriesoftheankle:CarrJBAnklefractures:MarschJL,SalzmanCLComposition:Bengt?stmanoverlegePresentation:SimenSellevold,assistentlegeIngoSpauke,assistentlege

Epidemiology02Incidence: 80–130per100000persons highestinelderlywomen 67%isolatedmalleolarfractures 25% bimalleolar 8% trimalleolar ANKLEFRACTURESNationalHospitalDischargeRegisterofFinland1994Court-BrownCM,McBirnieJ,WilsonG.Adultanklefractures:anincreasingproblem?ActaOrthopScand1998;69:43-47

03Incidence:RingerikeHospital1/82003–31/72004:184per70000-100000persons128/184(69%)isolatedmalleolarfractures27/184(15%)bimalleolar29/184(16%)trimalleolarANKLEFRACTURESEpidemiology

04ANKLEFRACTURESClassification-Why?Whydowerequirefractureclassifications?forclinicalresearchtounderstandtheliteratureasanaidtofracturedescriptionasanaidtofracturetreatment

05AO (Danis/Weber)TypeAbelowthesyndesmosisTypeBatthelevelofthesyndesmosisTypeCabovethesyndesmosisDanisR.Lesfracturesmalleolaires.In:DanisR,ed.Théorieetpractiquedel`osteosynthése.1949:133-165.

WeberBG.DieVerletzungendesoberenSprunggelenkes,Berne:HansHuber,1966.(2nded.1972)Classification–AO(Danis/Weber)ANKLEFRACTURES

06AO AO/OTA (Weber)3types(A,B,C)9groups(A1,A2,A3,B1,B2,B3,C1,C2,C3)27subgroups

MüllerME,Allg?werM,SchneiderR,etal..Manualofinternalfixation,2nded.Heidelberg:Springer-Verlag,1979:282-299.(3rded.1991).

OrthopaedicTraumaAssocoation.Fractureanddislocationcompendium.JOrthopTrauma1996;10:1-55.Classification–AO/OTAANKLEFRACTURES

07AO AO/OTA Lauge-HansenLauge-HansenN.Fracturesoftheankle:combinedexperimental-surgicalandexperimenta