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呼吁简化踝关节骨折的分类

A plea for simplicity in the classification of ankle fractures.

作者信息

Phillips R S, Monk C J, Balmer G A

出版信息

Postgrad Med J. 1968 Mar;44(509):199-211. doi: 10.1136/pgmj.44.509.199.

DOI:10.1136/pgmj.44.509.199
PMID:5648664
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2466373/
Abstract
  1. Ashurst and Bromer's classification of ankle fractures is a useful one, but falls into the complexities of subdivision into sequential progression of severity, i.e. ‘degrees’ of fracture. 2. A similar criticism can be made of the Lauge-Hansen classification which has an added semantic disadvantage. Doubts are also cast upon the validity of the direct application of experimental results in cadaveric specimens to a clinical series. 3. A third classification, essentially a modified form of those preceding it but with both an anatomical and a functional basis is presented, in the belief that it can provide evidence of: (a) the mechanism of production and hence the achievement of reduction; and (b) the recognition of significant ligamentous damage, i.e. the recognition of major from minor, stable from unstable injuries—when used in association with radiographs taken while straining the ankle under anaesthesia. 4. An Appendix to the paper (pp. 210-211), giving a more detailed account of our revised classification, is included.
摘要
  1. 阿舍斯特和布罗默对踝关节骨折的分类很有用,但它陷入了按照严重程度的连续进展进行细分的复杂性中,即骨折的“程度”。2. 对劳格 - 汉森分类也可提出类似的批评,该分类还有一个语义上的缺点。将尸体标本的实验结果直接应用于临床病例系列的有效性也受到质疑。3. 在此提出第三种分类,它本质上是前两种分类的一种改良形式,兼具解剖学和功能学基础,认为它能够提供以下证据:(a) 损伤机制以及复位的实现;(b) 识别重要的韧带损伤,即在与麻醉下对踝关节施加应力时拍摄的X线片联合使用时,区分主要损伤与次要损伤、稳定损伤与不稳定损伤。4. 本文附录(第210 - 211页)对我们修订后的分类做了更详细的说明。
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/5f1b12f5072f/postmedj00375-0012-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/c556c8f46bb1/postmedj00375-0007-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/3f27a4ea37d1/postmedj00375-0008-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/f5a05a34f4c5/postmedj00375-0009-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/bab74af5cb88/postmedj00375-0009-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/6f8fc7f86cb1/postmedj00375-0010-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/75955a871fdf/postmedj00375-0010-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/0edd4474d2f4/postmedj00375-0011-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/929dc9f3df79/postmedj00375-0011-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/5f1b12f5072f/postmedj00375-0012-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/c556c8f46bb1/postmedj00375-0007-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/3f27a4ea37d1/postmedj00375-0008-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/f5a05a34f4c5/postmedj00375-0009-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/bab74af5cb88/postmedj00375-0009-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/6f8fc7f86cb1/postmedj00375-0010-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/75955a871fdf/postmedj00375-0010-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/0edd4474d2f4/postmedj00375-0011-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/929dc9f3df79/postmedj00375-0011-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab4/2466373/5f1b12f5072f/postmedj00375-0012-a.jpg

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引用本文的文献

1
Preliminary study on the mechanisms of ankle injuries under falling and impact conditions based on the THUMS model.基于THUMS模型的坠落与冲击条件下踝关节损伤机制的初步研究
Forensic Sci Res. 2021 May 20;7(3):518-527. doi: 10.1080/20961790.2021.1875582. eCollection 2022.

本文引用的文献

1
Fractures of the ankle. II. Combined experimental-surgical and experimental-roentgenologic investigations.踝关节骨折。II. 实验外科与实验放射学联合研究
Arch Surg (1920). 1950 May;60(5):957-85.
2
Fractures of the ankle. IV. Clinical use of genetic roentgen diagnosis and genetic reduction.
AMA Arch Surg. 1952 Apr;64(4):488-500.
3
Fractures of the ankle. V. Pronation-dorsiflexion fracture.踝关节骨折。V. 旋前-背屈型骨折。
AMA Arch Surg. 1953 Dec;67(6):813-20. doi: 10.1001/archsurg.1953.01260040826004.