Lauge-Hansen分型与Danis-Webe分型为最常见的踝关节小腿分型，在对下肩胛骨约翰膝盖烧伤的指导意义上，旋后外旋II°小腿不一定认为分拆下肩胛骨约翰前膝盖的烧伤，下肩胛骨约翰为首趋于稳定，可能无才可下肩胛骨约翰为首螺钉固定。而Danis-Weber B型小腿定义为小腿毗邻下肩胛骨约翰为首水平，可能分拆下肩胛骨约翰为首烧伤。
由此可发现，对Danis-Weber B型小腿，如何分析下肩胛骨约翰有无烧伤，以及术前分析到底才可手术固定下肩胛骨约翰为首，仍无有效参考。
对此，国内外学者研究了Danis-Weber B型肌腱小腿线的右边，以求对比完全相同类型B型小腿下肩胛骨约翰为首烧伤比例到底存在差异，并指导手术干预。
Objective（旨在）确认术前X线检查和能否预测下肩胛骨约翰为首烧伤比率。[Objective: To establish if preoperative radiographs could predict the rate of syndesmotic injury.]
Patients/participants（流感）回顾了548例 OTA/AO 44-B2.1型病症，287例病症归属于研究。[Patients/participants: There were 548 OTA/AO 44-B2.1 fractures that were reviewed, and 287 patients were included in the study.]图1 流感归属于流程。
Main outcome measures（主要一集高效率）踝关节影像片用于明确肌腱小腿块的远距范围。下肩胛骨约翰为首烧伤定义为术中压力次测试表明并才可要下肩胛骨约翰固定。
[Main outcome measures: Ankle radiographs were used to determine the zone of distal extent of the proximal fracture fragment. Syndesmotic injury was defined as positive intraoperative stress examination that required syndesmotic fixation.]图2 Danis-Weber B型小腿，根据肌腱小腿块远至距右边分区外。1区外定义为小腿块远至距毗邻肱骨远距关节面平面请注意；2区外为毗邻肱骨远距骺线闭合瘢痕与远距关节面之有数；3区外为骺线闭合瘢痕以上。
图3 分区外示意图。
Results（结果）共有191例1区外(止于肱骨远距关节平面下方)烧伤，57处2区外(止于肱骨远距骨骺线闭合瘢痕和肱骨远距关节面之有数)烧伤，39处3区外(止于肱骨远距骨骺线闭合瘢痕以上)烧伤。其中，17% (33名病症)的1区外、42% (24名病症)的2区外和74% (29名病症)的3区外小腿分拆下肩胛骨约翰膝盖烧伤。
2区外与1区外来得，膝盖为首烧伤的相对于风险为2.4 (P，0.001)，3区外与1区外来得为4.3 (P，0.001)，3区外与2区外来得为1.8 (P = 0.002)。感知有数和感知内的可靠性非常好(k = 0.86，0.94)。
[Results: There were 191 zone 1 (ending below the plafond) injuries, 57 zone 2 (ending between the physeal scar and the plafond) injuries, and 39 zone 3 (ending above the physeal scar) injuries. Of these, 17% (33 patients) of zone 1, 42% (24) of zone 2, and 74% (29) of zone 3 fractures had syndesmotic injuries. The relative risk of syndesmotic injury of zone 1 compared with zone 2 was 2.4 (P , 0.001), zone 1 to zone 3 was 4.3 (P , 0.001), and zone 2 to zone 3 was 1.8 (P = 0.002). The interobserver and intraobserver reliability was excellent (k = 0.86, 0.94).]
表1 三组病症下肩胛骨约翰为首烧伤起因率。Conclusion（结论）OTA/AO 44-B2.1小腿具有完全相同的下肩胛骨约翰为首烧伤率。Weber B型小腿起因在肱骨远距关节平面和骺线闭合伤疤之有数(2区外)，与起因在关节面下方(1区外)的小腿来得，起因膝盖烧伤的可能性高2.4倍。这种可能性在骺线闭合伤疤上方(3区外)的烧伤中相当大。
OTA/AO 44-B2.1小腿的简单分类预见着膝盖烧伤，可能有助于术前咨询和手术计划规章。
[Conclusion: OTA/AO 44-B2.1 fractures he a varying rate of syndesmotic injury. Weber B fractures that end between the level of the plafond and the physeal scar (zone 2) are 2.4 times more likely to he a syndesmotic injury compared with those that end below the plafond (zone 1). This is magnified in those injuries ending above the scar (zone 3). This simple classification of OTA/AO 44-B2.1 fractures is predictive of syndesmotic injury and may aid in preoperative counseling and planning.]相关新闻
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