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首页> 外文期刊>Foot and ankle international >Supination External Rotational Ankle Fracture Injury Pattern Correlation With Regional Bone Density
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Supination External Rotational Ankle Fracture Injury Pattern Correlation With Regional Bone Density

机译：索取外部旋转踝部断裂损伤模式与区域骨密度的相关性

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摘要

Background: Rotational ankle fractures can present with an array of possible osseous and ligamentous injury combinations in reliable anatomic locations. What accounts for these different injury patterns and whether specific patient and injury factors underlie the different injury patterns is unclear. The purpose of this study was to determine whether causative factors exist that could account for the various injury patterns seen with rotational ankle fractures. Methods: A registry of operatively treated supination external rotation stage IV (SER IV) ankle fractures was used to identify patients. Computed tomography imaging was used to calculate regional bone density by using average Hounsfield unit measurements on axial images from the distal tibia and fibula. Patients were grouped into those with no posterior or medial malleolar fracture (equivalent group), those with either a posterior or medial malleolus fracture (bimalleolar group), and those with both posterior and medial malleolar fractures (trimalleolar group). Sixty-seven patients met inclusion criteria. Results: Regional bone density at the ankle, as measured with Hounsfield units, was significantly higher in the equivalent group (371) than in the bimalleolar group (271, P < .0001) and trimalleolar group (228, P < .0001). Logistic regression analyses identified regional bone density as a significant predictor of a medial malleolus fracture (P = .002) and of a posterior malleolus fracture (P = .005). Conclusion: In our cohort of SER IV ankle fractures, regional bone density at the ankle significantly correlated with the presence and number of malleolar fractures compared with ligamentous ruptures. Treating surgeons can use this information to anticipate bone quality during operative fixation based on ankle fracture injury pattern. In addition, the presence of a trimalleolar ankle fracture was a significant indicator of poor bone quality and may represent the first clinical sign of abnormal bone metabolism in many patients.
机译：背景：旋转脚踝骨折可以在可靠的解剖位置中存在一系列可能的骨质和韧性损伤组合。什么涉及这些不同的伤害模式以及特定的患者和伤害因素是否下降不同的伤害模式尚不清楚。本研究的目的是确定是否存在可能考虑使用旋转踝骨折的各种伤害模式的致病因素。方法：使用可操作处理的索取外旋转阶段IV（Ser IV）踝骨骨折的注册表鉴定患者。通过使用远端胫骨和腓骨的轴向图像上的平均Hounsfield单位测量，计算断层摄影成像用于计算区域骨密度。将患者分组到没有后部或内侧畸形骨折（等同基团）的那些中，那些有后或内侧麦芽糖骨折（Bimalleolar Group）的那些，以及与后侧和内侧陈列不良裂缝（Trimalleolar组）的那些。六十七名患者符合纳入标准。结果：用Hounsfield单元测量的脚踝处的区域骨密度在等效组（371）中显着高于Bimalleolar组（271，P <.0001）和Trimalleolar组（228，P <.0001）。逻辑回归分析将区域骨密度确定为内侧畸形骨折的显着预测因子（P = .002）和后畸形裂缝（P = .005）。结论：在我们的Ser IV踝关节骨折的队列中，与韧带破裂相比，踝关节的区域骨密度与恶性骨折的存在和数量显着相关。治疗外科医生可以使用这些信息来基于踝关节断裂损伤模式的手术固定期间预测骨质质量。此外，Trimalleolar踝部骨折的存在是骨质质量不佳的重要指标，并且可以代表许多患者中骨代谢异常的第一个临床迹象。

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