Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Foot Ankle Int. 2013 Nov;34(11):1516-20. doi: 10.1177/1071100713491730. Epub 2013 May 31.
Our aim was to assess whether the Lauge-Hansen (LH) and the Muller AO classification systems for ankle fractures radiographically correlate with in vivo injuries based on observed mechanism of injury.
Videos of potential study candidates were reviewed on YouTube.com. Individuals were recruited for participation if the video could be classified by injury mechanism with a high likelihood of sustaining an ankle fracture. Corresponding injury radiographs were obtained. Injury mechanism was classified using the LH system as supination/external rotation (SER), supination/adduction (SAD), pronation/external rotation (PER), or pronation/abduction (PAB). Corresponding radiographs were classified by the LH system and the AO system.
Thirty injury videos with their corresponding radiographs were collected. Of the video clips reviewed, 16 had SAD mechanisms and 14 had PER mechanisms. There were 26 ankle fractures, 3 nonfractures, and 1 subtalar dislocation. Twelve fractures with SAD mechanisms had corresponding SAD fracture patterns. Five PER mechanisms had PER fracture patterns. Eight PER mechanisms had SER fracture patterns and 1 had SAD fracture pattern. When the AO classification was used, all 12 SAD type injuries had a 44A type fracture, whereas the 14 PER injuries resulted in nine 44B fractures, two 44C fractures, and three 43A fractures.
When injury video clips of ankle fractures were matched to their corresponding radiographs, the LH system was 65% (17/26) consistent in predicting fracture patterns from the deforming injury mechanism. When the AO classification system was used, consistency was 81% (21/26). The AO classification, despite its development as a purely radiographic system, correlated with in vivo injuries, as based on observed mechanism of injury, more closely than did the LH system.
Level IV, case series.
我们的目的是评估踝关节骨折的 Lauge-Hansen（LH）和 Muller AO 分类系统是否与基于观察到的损伤机制的体内损伤具有放射性相关性。
在 YouTube.com 上查看潜在研究对象的视频。如果可以通过高可能性的损伤机制对视频进行分类，从而导致踝关节骨折，则将个体招募参与研究。获取相应的损伤 X 射线照片。使用 LH 系统将损伤机制分类为旋后-外旋（SER）、旋前-内收（SAD）、旋前-外旋（PER）或旋前-外展（PAB）。使用 LH 系统和 AO 系统对相应的 X 射线照片进行分类。
共收集了 30 个具有相应 X 射线照片的损伤视频。在审查的视频剪辑中，有 16 个具有 SAD 机制，有 14 个具有 PER 机制。有 26 例踝关节骨折，3 例非骨折，1 例距下关节脱位。具有 SAD 机制的 12 例骨折中有 12 例具有相应的 SAD 骨折模式。具有 PER 机制的 5 例中有 5 例具有 PER 骨折模式。具有 PER 机制的 8 例中有 8 例具有 SER 骨折模式，1 例具有 SAD 骨折模式。当使用 AO 分类时，所有 12 例 SAD 型损伤均具有 44A 型骨折，而 14 例 PER 损伤导致 9 例 44B 骨折、2 例 44C 骨折和 3 例 43A 骨折。
当将踝关节骨折的损伤视频片段与相应的 X 射线照片相匹配时，LH 系统在预测由变形损伤机制引起的骨折模式方面的一致性为 65%（17/26）。当使用 AO 分类系统时，一致性为 81%（21/26）。尽管 AO 分类系统是作为纯粹的放射学系统开发的，但与基于观察到的损伤机制的体内损伤的相关性比 LH 系统更密切。
IV 级，病例系列。
