Dhinsa Baljinder S, Latif Ahmed, Walker Roland, Abbasian Ali, Back Diane, Singh Sam
William Harvey Hospital, Kennington Road, Willesborough, Ashford TN24 0LZ, United Kingdom.
Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom.
Foot Ankle Surg. 2019 Jun;25(3):258-263. doi: 10.1016/j.fas.2018.02.004. Epub 2018 Feb 21.
There remains a lack of recognition of these fractures, which leads to a delay in diagnosis and appropriate management.
A comprehensive literature search was performed. Following inclusion and exclusion criteria, 23 studies were available for analysis.
Delay in diagnosis is common and has a negative impact on outcome. If an APC fracture is suspected; anteroposterior, lateral and oblique plain radiographs should be requested. Further investigation with computed tomography or magnetic resonance imaging is indicated if plain radiographs are inconclusive and patient remains symptomatic. Non-operative measures are usually adequate for most undisplaced fractures, however surgical intervention maybe required for large, intra-articular fractures in the acute setting and for non-union.
A treatment algorithm is suggested that may help with the diagnosis and management of these injuries.
Level IV.
这些骨折仍未得到充分认识，这导致诊断和恰当治疗的延迟。
进行了全面的文献检索。根据纳入和排除标准，有23项研究可供分析。
诊断延迟很常见，且对预后有负面影响。如果怀疑有APC骨折，应要求拍摄前后位、侧位和斜位X线平片。如果X线平片结果不明确且患者仍有症状，则需进一步进行计算机断层扫描或磁共振成像检查。对于大多数无移位骨折，非手术措施通常就足够了，然而对于急性情况下的大型关节内骨折和骨折不愈合，可能需要手术干预。
提出了一种治疗方案，可能有助于这些损伤的诊断和治疗。
四级。
