Sharma Bishnulatpam, Reddy Ippala Sreenath, Meanock Colin
Department of Emergency, Royal Berkshire Hospital, Reading, Berkshire, UK.
BMJ Case Rep. 2013 Jul 18;2013:bcr2013200105. doi: 10.1136/bcr-2013-200105.
This case is a rare adult type Tillaux fracture. This fracture should be diagnosed in the emergency department. The fracture requires careful evaluation with awareness of associated injury. Standard radiological views (antero-posterior and lateral) of the ankle may not clearly show the fracture displacement hence, an oblique view is required. The fracture should be managed by the emergency physician, if the displacement is less than 2 mm, by immobilising with a non-weight bearing cast or ankle braces for 6 weeks. If the fracture fragment is displaced more than 2 mm, it should be treated by closed reduction failing which open reduction and internal fixation is the standard practice.
该病例为罕见的成人型蒂洛骨折。此骨折应在急诊科进行诊断。骨折需要仔细评估，并警惕合并损伤。踝关节的标准放射学视图（前后位和侧位）可能无法清晰显示骨折移位情况，因此需要加拍斜位片。如果移位小于2毫米，急诊医生应通过使用非负重石膏或踝关节支具固定6周来处理该骨折。如果骨折块移位超过2毫米，则应进行闭合复位，若复位失败，切开复位内固定是标准治疗方法。
