Meenen N M, Lorke D E, Westerhoff M, Dallek M, Jungbluth K H
Abteilung für Unfall- und Wiederherstellungschirurgie, Universitätskrankenhaus Hamburg-Eppendorf.
Unfallchirurgie. 1993 Apr;19(2):98-107. doi: 10.1007/BF02588088.
25 rare isolated fractures of the dorsal tibial margin out of 2500 ankle-lesions have been analysed. The mechanism consists of extensive plantar flexion followed by axial impact of the astragalus against the posterolateral part of the mortise. The tense condition of the syndesmotic apparatus forces it to pull off the dorsal insertion wedge on the distal tibia with an articular component of different size. Small and undislocated fragments are prevalent. Torn anterior tibiofibular ligament and parts of the interosseous membrane are typical concomitants of this lesion. Neither fibular nor medial structures of the ankle joint have been harmed. Orthotopic bony union of the tibial margin and ligament healing is safe within three weeks of non-weight-bearing immobilisation followed by the same period of walking cast. Large dislocated fragments require operation. Most patients have excellent or good results as our follow-up study confirms.
在2500例踝关节损伤中，对25例罕见的胫骨背侧缘孤立性骨折进行了分析。其机制为踝关节过度跖屈，随后距骨轴向撞击关节窝后外侧部分。下胫腓联合装置处于紧张状态，迫使带有不同大小关节成分的背侧插入楔形骨块从胫骨远端撕脱。小的、未移位的骨折块较为常见。胫腓前韧带撕裂和部分骨间膜损伤是该损伤的典型伴随情况。踝关节的腓骨及内侧结构均未受损。在非负重固定三周，随后再使用行走石膏固定相同时间后，胫骨边缘的原位骨愈合及韧带愈合是安全的。大的移位骨折块需要手术治疗。我们的随访研究证实，大多数患者的结果为优或良。
