踝骨折

最后审阅: 2 六月 2022
最后更新: 29 七月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 近期外伤
  • 踝关节疼痛和肿胀
  • 不能负重
  • 内踝和/或外踝肿胀和触痛
更多 关键诊断因素

其他诊断因素

  • 摔倒时“啵”的一声
  • 踝关节畸形
  • 捻发音
  • 腓骨近端触痛
  • 内踝表面皮肤顶起
  • 渥太华踝关节规则
  • 骨质疏松症病史
  • 频繁跌倒史
  • 血管损害
其他诊断因素

危险因素

  • 骨质疏松症
  • 多次摔伤
  • 低能量摔伤
  • 踝关节内翻损伤
  • 运动损伤
更多 危险因素

诊断性检查

首要检查

  • X 线平片
更多 首要检查

需考虑的检查

  • X 线平片“应力位图”或站立正位 X 片
  • CT
  • 核磁共振成像 (MRI)
更多 需考虑的检查

治疗流程

初步治疗

开放性骨折

闭合骨折脱位

急症处理

单纯外踝骨折

单纯内踝骨折

双踝和三踝骨折

撰稿人

作者

Ewout S. Veltman, MD

Resident Orthopaedic Surgery

Joint Research

OLVG

Amsterdam

The Netherlands

利益声明

ESV declares that he has no competing interests.

Rudolf W. Poolman, MD, PhD

Consultant Orthopaedic Surgeon

Joint Research

Onze Lieve Vrouwe Gasthuis

Amsterdam

The Netherlands

利益声明

RWP has been a member of the Dutch Orthopedic Association Committee, has received grants for the ZonMW ESCAPE trial, DART trial, Achmea Escape trial and Van Rens Fonds REDEP trial, and has contributed to the following educational events: the Waldemar Link hip course and the J&J hip course.

鸣谢

Dr Ewout S. Veltman and Dr Rudolf W. Poolman would like to gratefully acknowledge Dr Mohit Bhandari and Dr Brad Petrisor, previous contributors to this topic, as well as Dr Victor A. van de Graaf and Dr Dirk P. ter Meulen for their assistance with the final draft. MB and BP declare that they have no competing interests.

同行评议者

Charles Court-Brown, MB ChB

Professor of Orthopaedic Surgery

Consultant Orthopaedic Surgeon

Edinburgh Orthopaedic Trauma Unit

Royal Infirmary of Edinburgh

Edinburgh

UK

利益声明

CCB is an author of several references cited in this topic.

James C. Puffer, MD

Professor

University of Kentucky School of Medicine

President and Chief Executive Officer

American Board of Family Medicine

Lexington

KY

利益声明

JCP declares that he has no competing interests.

Philip H. Cohen, MD

Clinical Assistant Professor of Medicine

Robert Wood Johnson Medical School

University of Medicine and Dentistry of New Jersey

Piscataway

NJ

利益声明

PHC declares that he has no competing interests.

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