踝关节骨折：调查与治疗选择。
Fractures of the ankle joint: investigation and treatment options.
机构信息
Department of Orthopedic and Trauma Surgery, University Hospital Bonn, Orthopedic Department at the University Hospital of Basel, Switzerland, HG and MDW have equally contributed to the manuscript.
出版信息
Dtsch Arztebl Int. 2014 May 23;111(21):377-88. doi: 10.3238/arztebl.2014.0377.
BACKGROUND
Ankle fractures are common, with an incidence of up to 174 cases per 100 000 adults per year. Their correct classification and treatment are of decisive importance for clinical outcome.
METHOD
Selective review of the literature.
RESULTS
Ankle fractures are initially evaluated by physical examination and then by x-ray. They can be classified according to either the AO Foundation (Association for the Study of Internal Fixation) or the Weber classification. Dislocated fractures need emergency treatment with immediate reduction; this is crucial for the prevention of hypoperfusion and nerve damage. Weber A fractures can usually be treated conservatively, while Weber B and C fractures are usually treated with surgery. An evaluation of the stability of the syndesmosis is important for anatomical reconstruction of the joint. Wound hematoma and wound-edge necrosis are the most common complications, and the postoperative infection rate is 2%. Up to 10% of patients develop ankle arthrosis over the intermediate or long term.
CONCLUSION
With properly chosen treatment, a good clinical outcome can be achieved. The long-term objective is to prevent post-traumatic ankle arthrosis. The evidence level for optimal treatment strategies is low.
背景
踝关节骨折很常见，成年人每年的发病率高达每 10 万人 174 例。正确的分类和治疗对临床结果具有决定性意义。
方法
文献的选择性回顾。
结果
踝关节骨折首先通过体格检查，然后通过 X 射线进行评估。它们可以根据 AO 基金会（内固定研究协会）或 Weber 分类进行分类。脱位骨折需要紧急治疗，立即复位；这对于防止灌注不足和神经损伤至关重要。Weber A 型骨折通常可以保守治疗，而 Weber B 和 C 型骨折通常需要手术治疗。距骨间关节稳定性的评估对于关节的解剖重建很重要。血肿和创缘坏死是最常见的并发症，术后感染率为 2%。高达 10%的患者在中期或长期会出现踝关节关节炎。
结论
选择适当的治疗方法可以获得良好的临床效果。长期目标是预防创伤后踝关节关节炎。最佳治疗策略的证据水平较低。
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