摘要

Six athletes, all engaged in running activities at the time of injury, presented with tenderness over the medial malleolus and ankle effusion. Three patients had a fracture line which could be seen on radiographs. These patients were treated by open reduction and internal fixation using two 4.0 cancellous screws. The other three patients had normal radiographs but bone scans showed increased uptake over the medial malleolus. These patients were treated with cast and immobilization. We believe that each of these patients suffered a stress fracture of the medial malleolus. We suggest that the possibility of a stress fracture be considered in the differential diagnosis of patients who present with 1) chronic or subacute pain over the medial malleolus and ankle effusion, and 2) a history of running activity at the time of injury or running activities aggravating the pain. Bone scans appear to be more sensitive than radiographs in detecting a stress fracture of the medial malleolus. We propose that athletes with radiographic signs of a medial malleolar fracture who desire early return to full participation should be treated by open reduction and internal fixation. For these patients, early motion can be initiated. Other athletes whose fracture cannot be detected on radiographs but whose malleolus shows increased uptake in the area on bone scans can be treated nonsurgically with immobilization and then progressive increase in activity. All of our patients returned to full activity between 6 and 8 weeks after treatment was initiated.

译文

六名运动员在受伤时都从事跑步活动,表现为内踝压痛和踝关节积液。三名患者的骨折线可以在 x光片上看到。这些患者使用两个 4.0 松质骨螺钉进行切开复位内固定治疗。另外三个病人有正常的 x光照片,但是骨扫描显示内踝摄取增加。这些病人用石膏和制动治疗。我们相信这些病人都遭受了内踝应力性骨折。我们建议在对出现 1) 慢性或亚急性内踝疼痛和踝关节积液,以及 2) 的患者进行鉴别诊断时考虑应力性骨折的可能性受伤时的跑步活动史或增加疼痛的跑步活动史。骨扫描在检测内踝应力性骨折方面似乎比 x线照片更敏感。我们建议,有内踝骨折影像学迹象的运动员,如果希望尽早恢复完全参与,应采用切开复位内固定治疗。对于这些患者,可以启动早期运动。其他运动员的骨折不能在 x光片上被检测到,但他们的踝显示在骨骼扫描区域的吸收增加,可以通过非手术固定治疗,然后逐步增加活动。我们所有的患者在开始治疗后的 6 到 8 周内恢复到完全活动状态。

Medial malleolus

骨科 骨折 临床研究术语
概述  :  

内踝是指脚部与腿胫骨和腓骨连接的踝关节附近内侧隆起的部位,双脚的脚内踝在人立正时可以靠近或贴近,双足内踝最偏中线的顶点称为内踝尖。 内踝常见病变内踝处临床中最常见的疾病为骨折,踝关节骨折属于一种较为常见的骨折类型。 当合并内踝骨折时,会给患者的踝关节造成极为严重的影响,而且在病情较为严重的情况下,甚至可能导致患者丧失行走能力,对患者的生活质量以及身体健康均造成了严重影响。 手术方式由于内踝骨折需要解剖复位,并且多合并外踝的骨折,所以首先应固定外踝,固定外踝后采用2枚长度为

Medial 英 /ˈmiːdiəl/  美 /ˈmiːdiəl/    

释    义   adj. 中间的;平均的;普通的

n. [语]中间字母

同根词   medially adv.平均地,居中地;一般地;mediacy n.调解;中间状态;媒介;mediant n.中音;[数]中间数

例    句   Therefore, it is important to be able to inspect the medial aspect of the joint concerned during surgery.因此,在手术中检查关节的内侧是很重要的。

 

Malleolus 英 /mæ'liːələs/  美 /mə'liələs/      

释    义   n. [解剖]踝

复数 malleoli

同根词   distance n.距离

例    句   Then subluxate the talus and malleolus laterally to reach the joint surfaces.然后将距骨及内膘踝向外侧半脱位,显露关节面。


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