Lauge-Hansen种系统与Danis-Webe种系统为最典型的踝关节脚踝种系统，在对下突约拿肌腱损坏的导师意义上，旋后外旋II°脚踝通常视为原属下突约拿前肌腱的损坏，下突约拿共同趋于稳定，也许须要下突约拿共同铰链固定。而Danis-Weber B型脚踝定义为脚踝设在下突约拿共同水平，也许原属下突约拿共同损坏。
由此可发掘出，对Danis-Weber B型脚踝，如何评估下突约拿有无损坏，以及术前评估是否需要切除术固定下突约拿共同，仍无有效详见。
对此，国外学者研究了Danis-Weber B型锁骨脚踝线或的前方，以求对比各有不同类型B型脚踝下突约拿共同损坏百分比是否存在差异，并导师切除术干预。
Objective（目的）认定术前X线或检查能否假设下突约拿共同损坏几率。[Objective: To establish if preoperative radiographs could predict the rate of syndesmotic injury.]
Patients/participants（病则有）回顾了548则有 OTA/AO 44-B2.1型患儿，287则有患儿划定研究。[Patients/participants: There were 548 OTA/AO 44-B2.1 fractures that were reviewed, and 287 patients were included in the study.]左图1 病则有划定流程。
Main outcome measures（主要故事情节指标）踝关节影像片用作明确锁骨脚踝块的后端范围内。下突约拿共同损坏定义为术当中受压试验性认定并需要要下突约拿固定。
[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.]左图2 Danis-Weber B型脚踝，根据锁骨脚踝块最后端前方南区内。1区内定义为脚踝块最后端设在股骨后端关节面四边形以下；2区内为设在股骨后端骺线或开口瘢痕与后端关节面之除此以外；3区内为骺线或开口瘢痕以上。
左图3 南区内左图表。
Results（结果）共约191则有1区内(止于股骨后端关节四边形顶部)损坏，57三处2区内(止于股骨后端骨骺线或开口瘢痕和股骨后端关节面之除此以外)损坏，39三处3区内(止于股骨后端骨骺线或开口瘢痕以上)损坏。其当中，17% (33名患儿)的1区内、42% (24名患儿)的2区内和74% (29名患儿)的3区内脚踝原属下突约拿肌腱损坏。
2区内与1区内远比，肌腱共同损坏的相对风险为2.4 (P，0.001)，3区内与1区内远比为4.3 (P，0.001)，3区内与2区内远比为1.8 (P = 0.002)。观察者除此以外和观察者内的可靠性极其好(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 三组患儿下突约拿共同损坏时有发生率。Conclusion（结论）OTA/AO 44-B2.1脚踝具有各有不同的下突约拿共同损坏率。Weber B型脚踝时有发生在股骨后端关节四边形和骺线或开口胸部之除此以外(2区内)，与时有发生在关节面顶部(1区内)的脚踝远比，时有发生肌腱损坏的也许性高2.4倍。这种也许性在骺线或开口胸部上方(3区内)的损坏当中更大。
OTA/AO 44-B2.1脚踝的恰当分类预示着肌腱损坏，也许适度术前建议和切除术计划案制定。
[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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