Segal D
Instr Course Lect. 1984;33:107-17.
Ankle fractures are common in young adults, often resulting from athletic activities. They can be subdivided into stable and unstable fractures. The unstable fracture consists of bone or a combined bone and ligamentous injury. In an unstable fracture the talus is displaced 2 mm or more and open reduction with internal fixation is recommended. Good functional results depend on three factors--anatomic restoration of the articulating surfaces, early range of motion, and early weight bearing. The role of early weight bearing is emphasized as a significant factor in contributing to good functional results. Based on our clinical experience with the nonathletic patient, 10 degrees of dorsiflexion is required for normal activities. Dorsiflexion has been noted to be a significant movement, and its limitation causes more disability than limited plantar flexion. A below-knee orthosis was described that enables the patient to ambulate and exercise dorsiflexion and plantar flexion, minimizing rotational forces acting on the ankle.
踝关节骨折在年轻人中很常见，通常由体育活动引起。它们可分为稳定骨折和不稳定骨折。不稳定骨折包括骨损伤或合并的骨与韧带损伤。在不稳定骨折中，距骨移位2毫米或更多，建议进行切开复位内固定。良好的功能结果取决于三个因素——关节面的解剖复位、早期活动范围和早期负重。早期负重的作用被强调为有助于取得良好功能结果的一个重要因素。根据我们对非运动员患者的临床经验，正常活动需要10度的背屈。背屈被认为是一个重要的动作，其受限比跖屈受限导致更多的残疾。描述了一种膝下矫形器，它能使患者行走并进行背屈和跖屈运动，将作用于踝关节的旋转力降至最低。
