Krause Fabian, Seidel Angela
Departement für Orthopädische Chirurgie, Inselspital, Universität Bern, Schweiz.
Departement für Orthopädische Chirurgie, HFR, Universität Freiburg, Schweiz.
Ther Umsch. 2022 Sep;79(7):338-342. doi: 10.1024/0040-5930/a001371.
Malleolar Fractures - Indication for Nonoperative and Operative Treatment In order to understand the trauma mechanism and the expected pattern of injury, malleolar fractures can be classified according to Lauge-Hansen [1]. For isolated lateral malleolar fractures, the Weber classification is also frequently used [2]. For most Weber A fractures and 80% of Weber B fractures conservative treatment is indicated. In all isolated Weber B fractures a supination-external rotation (SER) injury has to be distinguished from a pronation-abduction (PA) injury according to the Lauge-Hansen classification. In SER fractures, stability should be assessed by a gravity stress and a weightbearing radiograph. If the fracture is stable, it can be treated nonoperatively. We recommend surgical treatment for unstable Weber B SER injuries, Weber B PA injuries, and Weber C fractures.
踝关节骨折——非手术及手术治疗的指征 为了解创伤机制及预期的损伤类型，踝关节骨折可根据劳格-汉森分类法进行分类[1]。对于单纯的外踝骨折，也经常使用韦伯分类法[2]。对于大多数韦伯A型骨折和80%的韦伯B型骨折，建议采取保守治疗。根据劳格-汉森分类法，在所有单纯的韦伯B型骨折中，必须区分旋后-外旋（SER）损伤和旋前-外展（PA）损伤。在SER骨折中，应通过重力应力试验和负重X线片评估稳定性。如果骨折稳定，可进行非手术治疗。对于不稳定的韦伯B型SER损伤、韦伯B型PA损伤和韦伯C型骨折，我们建议进行手术治疗。
