Baumann Andreas
Department of Trauma and Orthopaedic Surgery, Lancashire Teaching Hospitals, Sharoe Green Lane, PR2 9HT, Preston, Großbritannien.
Unfallchirurg. 2021 Mar;124(3):175-180. doi: 10.1007/s00113-021-00960-5. Epub 2021 Feb 11.
Stable ankle fractures can be successfully managed nonoperatively. Unstable fractures on the other hand should be treated surgically as operative management consistently leads to better outcomes. How to define stability in ankle fractures continues to be a controversial issue. Better understanding of the mechanism of injury as well as improved knowledge of ankle biomechanics now enables surgeons to define stability after isolated fractures of the distal fibula with high accuracy. The following article describes commonly used methods to assess ankle stability after isolated fractures of the lateral malleolus, including stress tests and the use of weight-bearing radiographs. By adhering to the described criteria more than 90% of all isolated nondisplaced fractures of the distal fibula can be managed nonoperatively with excellent results.
稳定型踝关节骨折可以通过非手术方法成功治疗。另一方面,不稳定骨折应进行手术治疗,因为手术治疗始终能带来更好的结果。如何定义踝关节骨折的稳定性仍然是一个有争议的问题。对损伤机制的更好理解以及对踝关节生物力学的更多了解,现在使外科医生能够高精度地定义腓骨远端孤立骨折后的稳定性。以下文章描述了评估外踝孤立骨折后踝关节稳定性的常用方法,包括应力测试和负重X线片的使用。通过遵循所述标准,超过90%的所有腓骨远端孤立无移位骨折可以通过非手术方法治疗并取得优异结果。