Ogden J A, Lee J
Shriners Hospital for Crippled Children, University of South Florida, Tampa 33612-9499.
J Pediatr Orthop. 1990 May-Jun;10(3):306-16. doi: 10.1097/01241398-199005000-00003.
An accessory, distal focus of epiphyseal ossification may develop in either malleolus. These foci are not anatomically separate entities, even though they appear to be radiographically. They usually are asymptomatic. However, they may be injured, either acutely or chronically. The diagnosis of such injury by conventional radiography is limited. Bone scintigraphy may be positive if there is a stress fracture. The fracture pattern, a type 7 growth mechanism injury, extends through a segment of the malleolus. An ossicle may also be avulsed as a ligament failure analogue, similar to a sleeve fracture of the patella. This is more common in the lateral than in the medial malleolus. These avulsions, if not adequately diagnosed and treated, may progress to delayed union, nonunion, or a chronically painful ankle.
在任何一侧的踝关节，可能会出现一个附属的、位于远端的骨骺骨化中心。这些骨化中心在解剖学上并非独立的实体，尽管在放射学影像上它们看起来是独立的。它们通常没有症状。然而，它们可能会受到急性或慢性损伤。通过传统放射学检查对此类损伤的诊断有限。如果存在应力性骨折，骨闪烁显像可能呈阳性。骨折类型为7型生长机制损伤，贯穿踝关节的一部分。小骨也可能像韧带断裂类似情况一样被撕脱，类似于髌骨的袖状骨折。这种情况在外侧踝关节比在内侧踝关节更常见。这些撕脱伤如果没有得到充分的诊断和治疗，可能会发展为延迟愈合、不愈合或慢性疼痛的踝关节。
