Xarchas Konstantinos, Kitridis Dimitrios, Georgiannos Dimitrios, Givissis Panagiotis
Department of Orthopaedics, Georgios Gennimatas Hospital, Athens, Greece.
Department of Orthopaedics, 424 Army General Training Hospital, Thessaloniki, Greece.
J Orthop Case Rep. 2019;9(4):51-53. doi: 10.13107/jocr.2019.v09.i04.1476.
Lauge-Hansen classification for ankle fractures is helpful in directing the management of the fracture and has got prognostic significance. However, trimalleolar fractures with double medial malleolar fracture are not yet described.
Two cases of trimalleolar fracture-dislocation of the ankle with a double fracture of the medial malleolus are reported. Both of them had a Weber B fracture of the lateral malleolus, accompanied by a posterior dislocation of the ankle and a fracture of the posterior malleolus. The medial malleolus though presented an interesting variation, a large vertical or oblique fragment was combined with a small horizontal fragment of its tip.
We propose a separate subtype in the Lauge-Hansen classification of supination with combined external rotation and adduction when this pattern of the medial malleolus is accounted. Awareness of this fracture pattern will help better pre-operative planning.
Lauge-Hansen踝关节骨折分类有助于指导骨折的治疗，并具有预后意义。然而，双内踝骨折的三踝骨折尚未见报道。
报告两例踝关节三踝骨折脱位合并双内踝骨折。两例均为外踝Weber B型骨折，伴有踝关节后脱位及后踝骨折。内踝呈现出一种有趣的变异，一个大的垂直或斜形骨折块与其尖端的一个小的水平骨折块相连。
当考虑到这种内踝骨折类型时，我们建议在Lauge-Hansen旋后合并外旋和内收型分类中单独设立一个亚型。认识这种骨折类型将有助于更好地进行术前规划。
