Lauge-Hansen分型与Danis-Webe分型为最相似的踝腿部扭伤分型，在对下胸骨罗尼脚踝受损的指导意义上，旋后外旋II°扭伤通常认为拆分下胸骨罗尼前脚踝的受损，下胸骨罗尼为首趋于稳定，确实不须下胸骨罗尼为首链条通常。而Danis-Weber B型扭伤定义为扭伤位于下胸骨罗尼为首水平，确实拆分下胸骨罗尼为首受损。
由此可发现，对Danis-Weber B型扭伤，如何审计下胸骨罗尼有无受损，以及术前审计究竟需移植手术通常下胸骨罗尼为首，仍无有效参考。
反驳，国外学者研究者了Danis-Weber B型肌腱扭伤本站的位置，以求对比不同类型B型扭伤下胸骨罗尼为首受损比事例究竟假定差异，并指导移植手术干预。
Objective（目的）认定术前X本站检测能否预测下胸骨罗尼为首受损有可能。[Objective: To establish if preoperative radiographs could predict the rate of syndesmotic injury.]
Patients/participants（病事例）简述了548事例 OTA/AO 44-B2.1型病征，287事例病征纳入研究者。[Patients/participants: There were 548 OTA/AO 44-B2.1 fractures that were reviewed, and 287 patients were included in the study.]图1 病事例纳入程序。
Main outcome measures（主要结局指标）踝腿部影像片用于明确肌腱扭伤块的后端范围。下胸骨罗尼为首受损定义为术中压力试验性证实并需要下胸骨罗尼通常。
[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型扭伤，根据肌腱扭伤块最后端位置分四区。1四区定义为扭伤块最后端位于胸骨骨后端腿部面平面以下；2四区为位于胸骨骨后端骺本站闭合瘢痕与后端腿部面二者之间；3四区为骺本站闭合瘢痕以上。
图3 分四区示意图。
Results（结果）共有191事例1四区(唯于胸骨骨后端腿部平面顶部)受损，57所在位置2四区(唯于胸骨骨后端骨骺本站闭合瘢痕和胸骨骨后端腿部面二者之间)受损，39所在位置3四区(唯于胸骨骨后端骨骺本站闭合瘢痕以上)受损。其中，17% (33名病征)的1四区、42% (24名病征)的2四区和74% (29名病征)的3四区扭伤拆分下胸骨罗尼脚踝受损。
2四区与1四区相对于，脚踝为首受损的相对风险为2.4 (P，0.001)，3四区与1四区相对于为4.3 (P，0.001)，3四区与2四区相对于为1.8 (P = 0.002)。观察者间和观察者内的可靠性非常好(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 三组病征下胸骨罗尼为首受损发生率。Conclusion（推论）OTA/AO 44-B2.1扭伤带有不同的下胸骨罗尼为首受损率。Weber B型扭伤发生在胸骨骨后端腿部平面和骺本站闭合伤疤二者之间(2四区)，与发生在腿部面顶部(1四区)的扭伤相对于，发生脚踝受损的确实性高2.4倍。这种确实性在骺本站闭合伤疤上方(3四区)的受损中较小。
OTA/AO 44-B2.1扭伤的有趣分类预示着脚踝受损，确实最大限度术前咨询和移植手术计划制定。
[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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