Lauge-Hansen种系统与Danis-Webe种系统为最类似的踝关节膝盖种系统，在对下小腿里斯腱伤害的指导意义上，旋后外旋II°膝盖通常认为原属下小腿里斯前腱的伤害，下小腿里斯倡议发生变化，也许必需下小腿里斯倡议螺钉互换。而Danis-Weber B同型膝盖假设为膝盖位于下小腿里斯倡议水平，也许原属下小腿里斯倡议伤害。
由此可见到，对Danis-Weber B同型膝盖，如何评量下小腿里斯有无伤害，以及术前评量是否需切除术互换下小腿里斯倡议，仍无有效参考。
对此，欧美国家学者深入研究了Danis-Weber B同型近前端膝盖线或的前面，以求对比并不相同类别B同型膝盖下小腿里斯倡议伤害比同上是否存在差异，并指导切除术干预。
Objective（目地）确认术前X线或检查能否预测下小腿里斯倡议伤害几率。[Objective: To establish if preoperative radiographs could predict the rate of syndesmotic injury.]
Patients/participants（病同上）回顾了548同上 OTA/AO 44-B2.1同型患者，287同上患者划入深入研究。[Patients/participants: There were 548 OTA/AO 44-B2.1 fractures that were reviewed, and 287 patients were included in the study.]图1 病同上划入流程。
Main outcome measures（主要上集指标）踝关节相片片用于明确近前端膝盖块的远前端适用范围。下小腿里斯倡议伤害假设为术中会压力飞行测试证实并只能下小腿里斯互换。
[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同型膝盖，根据近前端膝盖块更远前端前面分一区。1一区假设为膝盖块更远前端位于肱骨远前端关节面对称下述；2一邻近位于肱骨远前端骺线或的环瘢痕与远前端关节面密切关系；3一邻近骺线或的环瘢痕以上。
图3 分一区示意图。
Results（结果）总共191同上1一区(应于于肱骨远前端关节对称左侧)伤害，57两处2一区(应于于肱骨远前端骨骺线或的环瘢痕和肱骨远前端关节面密切关系)伤害，39两处3一区(应于于肱骨远前端骨骺线或的环瘢痕以上)伤害。其中会，17% (33名患者)的1一区、42% (24名患者)的2一区和74% (29名患者)的3一区膝盖原属下小腿里斯腱伤害。
2一区与1一区相对，腱倡议伤害的相对较风险为2.4 (P，0.001)，3一区与1一区相对为4.3 (P，0.001)，3一区与2一区相对为1.8 (P = 0.002)。假定间和假定内的可靠性相当好(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 2组患者下小腿里斯倡议伤害再次发生率。Conclusion（结论）OTA/AO 44-B2.1膝盖不具并不相同的下小腿里斯倡议伤害率。Weber B同型膝盖再次发生在肱骨远前端关节对称和骺线或的环额头密切关系(2一区)，与再次发生在关节面左侧(1一区)的膝盖相对，再次发生腱伤害的也许性高2.4倍。这种也许性在骺线或的环额头上方(3一区)的伤害中会更大。
OTA/AO 44-B2.1膝盖的简单分类预示着腱伤害，也许有利于术前政府部门和切除术计划制定。
[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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