Kwon John Y, Gitajn Ida Leah, Walton Phillip, Miller Timothy J, Appleton Paul, Rodriguez Edward K
Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215. E-mail address for J.Y. Kwon:
Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02115.
J Bone Joint Surg Am. 2015 Apr 1;97(7):604-9. doi: 10.2106/JBJS.N.00970.
The study by Lauge-Hansen published in the Archives of Surgery in 1950 still stands as the seminal work for our understanding of the pathomechanics of ankle fractures. The purpose of the present study was to recreate Lauge-Hansen's experiments for the supination-external rotation (SER) fracture mechanism and to determine whether the predicted sequence of osseous and soft-tissue injury is reproducible on the basis of his originally described methodology.
Ten fresh-frozen cadaver specimens amputated above the knee were utilized. The foot was axially loaded in a position of neutral dorsiflexion and supination. External rotation was applied manually in accordance with Lauge-Hansen's description until osseous and/or soft-tissue injury occurred. Fluoroscopic images were made and anatomic dissection was performed.
Although several specimens exhibited findings consistent with certain stages of the SER injury pattern, no specimen demonstrated the complete sequence of predicted osseous and soft-tissue injury.
Loading cadaver specimens with an SER mechanism utilizing a methodology similar to that in the original experiments by Lauge-Hansen does not reliably produce the sequence of osseous and soft-tissue injury predicted by Lauge-Hansen.
1950年发表于《外科学文献》的Lauge-Hansen研究至今仍是我们理解踝关节骨折病理力学的开创性著作。本研究的目的是重现Lauge-Hansen关于旋后-外旋（SER）骨折机制的实验，并根据他最初描述的方法确定预测的骨与软组织损伤顺序是否可重复。
使用10个膝关节以上截肢的新鲜冷冻尸体标本。足部在中立背屈和旋后位进行轴向加载。按照Lauge-Hansen的描述手动施加外旋，直至发生骨和/或软组织损伤。进行荧光透视成像并进行解剖。
尽管几个标本表现出与SER损伤模式某些阶段一致的结果，但没有标本显示出预测的骨与软组织损伤的完整顺序。
采用与Lauge-Hansen原始实验类似的方法，以SER机制加载尸体标本，不能可靠地产生Lauge-Hansen预测的骨与软组织损伤顺序。
