Rigby Ryan B, Scott Ryan T
Logan Regional Orthopedics, 1350 North 500 East, Logan, UT 84321, USA.
CORE Institute, 9305 West Thomas Road #305, Phoenix, AZ 85023, USA.
Clin Podiatr Med Surg. 2018 Apr;35(2):183-197. doi: 10.1016/j.cpm.2017.12.003. Epub 2018 Feb 1.
Acute deltoid injuries may occur with ankle fractures. They are often left to heal without repair, possibly leading to chronic medial ankle instability. Stress radiographs identify the need for surgical repair of fractures or soft tissue damage. Gravity stress views have benefits over manually stressing the ankle. MRI can explore the extent of medial soft tissue injuries. Arthroscopy can evaluate and potentially treat deltoid injuries. Interposition of the deltoid may preclude adequate fracture reduction. Except with deltoid tear, fractures should be reduced and fixated, then the deltoid assessed. With persistent instability, primary repair may prevent long-term sequelae.
急性三角韧带损伤可能与踝关节骨折同时发生。它们常常未进行修复就任其自行愈合，这可能导致踝关节内侧慢性不稳定。应力位X线片可确定是否需要对骨折或软组织损伤进行手术修复。重力应力位片比手动对踝关节施加应力更具优势。磁共振成像（MRI）可探查内侧软组织损伤的程度。关节镜检查可评估并有可能治疗三角韧带损伤。三角韧带嵌入可能妨碍骨折的充分复位。除了三角韧带撕裂的情况外，骨折应先进行复位和固定，然后再评估三角韧带。对于持续存在的不稳定情况，一期修复可预防长期后遗症。
