We believed open reduction with internal fixation is required for supination-external rotation ankle fractures located at the level of the distal tibiofibular syndesmosis (Lauge-Hanssen SER II and Weber B) with 2 mm or more fibular fracture displacement. The rationale for surgery for these ankle fractures is based on the notion of elevated intraarticular contact pressures with lateral displacement. To diagnose these injuries, we presumed that in patients with a fibular fracture with at least 2 mm fracture displacement, the lateral malleolus and talus have moved at least 2 mm in a lateral direction without medial displacement of the proximal fibula. We reviewed 55 adult patients treated operatively for a supination-external rotation II ankle fracture (2 mm or more fibular fracture displacement) between 1990 and 1998. On standard radiographs, distance from the tibia to the proximal fibula, distance from the tibia to the distal fibula, and displacement at the level of the fibular fracture were measured. These distances were compared preoperatively and postoperatively. We concluded tibiotalar displacement cannot be reliably assessed at the level of the fracture. Based on this and other studies, we believe there is little evidence to perform open reduction and internal fixation of supination-external rotation II ankle fractures
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机译:我们认为,位于2毫米或更多腓骨骨折移位的远端胫腓联合症(Lauge-Hanssen SER II和Weber B)水平的旋后外旋踝关节骨折需要采用内固定进行切开复位术。这些踝部骨折手术的基本原理是基于侧向移位的关节内接触压力升高的概念。为了诊断这些损伤,我们假设患有腓骨骨折且骨折移位至少2 mm的患者,外侧踝和距骨在横向方向移动了至少2 mm,而近腓骨没有内侧移位。我们回顾了1990年至1998年之间接受旋后外旋II型踝关节骨折(2毫米或更多腓骨骨折移位)手术治疗的55名成年患者。在标准X线照片上,胫骨到腓骨近端的距离,胫骨到远端的距离测量腓骨腓骨骨折处的位移。术前和术后比较这些距离。我们得出结论,不能可靠地评估骨折水平的胫距骨位移。基于这项研究和其他研究,我们认为几乎没有证据可以进行旋切复位和内固定的旋后-外旋II型踝关节骨折
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