后踝骨折的生物力学分类与治疗

目的：对后踝骨折进行分类。用于指导临床治疗。方法：对入院患者进行物理检查。主要是对初次X线片进行测量、计算、归纳，28例根据手术所见。结果：本文通过对52例后踝骨折病例进行分析。发现后踝骨折是由于踝关节受到由后向前下的冲力及扭转应力，特别是在小腿处于内旋位时，距骨撞击后踝和下胫腓后韧带牵拉所致。依据（1）后踝骨折的生物力学机制；（2）后踝骨折移位的特点；（3）骨折波及关节面的损伤程度；（4）J 否合并周围组织损伤及踝穴的稳定状况，将后踝骨折分为Ⅲ度，得出了与之相应的治疗方案。应用本分类标准治疗52例后踝骨折，取得93.3%的优良率。结论：对后踝骨折实行分类，为临床治疗提出理论依据。

The Biomechanics Classification and Treatment of Fracture of Posterior Malleolus(FPM)

Objective To classify FPM and guide its clinical treatment.Method52 patientswere given physical examination.Informations were acquired mainly on the basis of measuresand calculations on the first of roentgenograms after fractures.28 of them on the basis ofthat were seen during operations.ResultsFPM are caused by the impulsive force form behindto front and the distorting stress on ankle.Especially when legs are on the position ofpronation and the talus strikes posterior malleolus, and posterior inferior tibiofibularligaments.FPM were classified into 3 degrees and corresponding treatments were offered onthe basis of (1)The biomechanics mechanism of FPM,(2)The transposing characterization ofFPM,(3)The degree that fractures injuried articular surface,(4)If surrounding tissues wereinjuried and the stable state of mortise.We applied the classification to treat 52patients of FPM.The rate of excellent and good results was 93.3%.ConclusionTo classifyFPM and provided guidance for clinical treatment.