Foot and Ankle Surgery Department, Honghui Hospital of Xi'an Jiaotong University, No. 76 Nanguo Road, Xi'an 710054, China.
BMC Musculoskelet Disord. 2024 Jul 26;25(1):585. doi: 10.1186/s12891-024-07688-4.
Logsplitter Injury is a type of high-energy ankle fracture dislocation. The mechanism of injury has not been described in detail. A detailed understanding of the radiological features and pathological changes can further guide treatment.
Between April 2009 and December 2018, a retrospective analysis was conducted on 62 patients with Logsplitter injury. The study analysed the characteristics of fibular injury, tibial injury, syndesmosis injury, medial injury and lateral ligament injury on preoperative X-ray and CT scans. The incidence of the different injury types was summarised. The correlation between Logsplitter injuries and the mechanisms causing them were analysed using the Lauge-Hansen classification of ankle fractures.
The study provides data on the types of fractures observed. Of the total fractures, 98.4% were open fractures. The fibula injuries were classified as no fracture (1.6%), transverse or short oblique fractures (61.3%), butterfly fragments (25.8%), and comminuted fractures (11.3%). The tibial injuries included compression of lateral articular surfaces (38.7%) and posterior compressions (6.5%). Medial injuries, including medial malleolar fractures, accounted for 87.1%, and deltoid ligament rupture accounted for 12.9%. The study found that injuries to the syndesmosis consisted of simple ligament ruptures (11.3%), Tillaux fractures (8.1%), Volkmann fractures (43.5%), and Tillaux and Volkmann fractures (37.1%). In 12.9% of cases, there was a complete rupture of the lateral collateral ligament. Based on the Lauge-Hansen classification, 87.1% of injuries were pronation-abduction injuries, while 8.1% were pronation and external rotation injuries, and 1.6% were supination external rotation injuries. Furthermore, 3.2% of cases could not be classified.
The pathoanatomic characteristics of Logsplitter injury are diverse, with some cases accompanied by collateral ligament injury. It is important to note that these evaluations are objective and based on current results. The most common injury mechanism is vertical violence combined with abduction, although in some cases, it may be a vertical combined external-rotation injury.
(4) case series.
This study has been approved by the ethical research committee of the Honghui Hospital of Xi'an Jiaotong University, under the code: 202,003,002.
劈木机伤是一种高能踝关节骨折脱位。损伤机制尚未详细描述。对影像学特征和病理变化的详细了解可以进一步指导治疗。
2009 年 4 月至 2018 年 12 月，对 62 例劈木机伤患者进行回顾性分析。本研究分析了术前 X 线和 CT 扫描中腓骨损伤、胫骨损伤、胫腓联合损伤、内侧损伤和外侧韧带损伤的特点。总结不同损伤类型的发生率。使用踝关节骨折的 Lauge-Hansen 分类分析劈木机伤与致伤机制的相关性。
本研究提供了观察到的骨折类型的数据。在所有骨折中，98.4%为开放性骨折。腓骨损伤分为无骨折（1.6%）、横断或短斜骨折（61.3%）、蝶形碎片（25.8%）和粉碎性骨折（11.3%）。胫骨损伤包括外侧关节面压缩（38.7%）和后压缩（6.5%）。内侧损伤包括内踝骨折，占 87.1%，三角韧带断裂占 12.9%。研究发现，胫腓联合损伤包括单纯韧带断裂（11.3%）、Tillaux 骨折（8.1%）、Volkmann 骨折（43.5%）和 Tillaux 和 Volkmann 骨折（37.1%）。在 12.9%的病例中，外侧副韧带完全断裂。根据 Lauge-Hansen 分类，87.1%的损伤为旋前外展损伤，8.1%为旋前外旋损伤，1.6%为旋后外旋损伤。此外，3.2%的病例无法分类。
劈木机伤的病理解剖特征多种多样，有些病例伴有侧副韧带损伤。需要注意的是，这些评估是客观的，基于当前的结果。最常见的损伤机制是垂直暴力加外展，尽管在某些情况下，可能是垂直加外旋损伤。
（4）病例系列。
本研究已获得西安交通大学红会医院伦理研究委员会的批准，编号：202,003,002。
