Ankle Fracture- SER Supination External Rotation (Eversion) скачать в хорошем качестве

Ankle Fracture- SER Supination External Rotation (Eversion)

With the foot in a fixed supinated position the forces start along the lateral axis of the fibula. The leg undergoes an internal rotation creating tension on the anterior inferior tibio-fibular ligament. In a Stage 1 injury, one of two pathologies may occur; rupture of the anterior inferior tibio-fibular ligament or a fracture of the distal lateral tibia (aka Tillaux-chaput fracture). As the leg continues to internally rotate the talus collides with the distal fibula, creating a spiral fracture of the fibula beginning at the level of the syndesmosis. This describes a Stage 2 injury, which is the most commonly encountered ankle fracture. A Wagstaffe fracture can also occur during this stage. As the force progresses a Stage 3 injury will either involve a rupture of the posterior tibio-fibular ligament or fracture of the posterior malleolus of the tibia (aka Volkman's fracture). Supination external rotation injuries that reach stage 3 rarely stop at this point and usually progresses to the final stage. Continued unrestrained lateral rotation of the talus will result in a Stage 4 injury involving either a rupture of the deltoid ligament complex or a transverse fracture of the medial malleolus. (Take home points) -The injury begins along the lateral axis of the fibula. -The spiral fracture seen in stage 2 is unique to supination-external rotation injuries.(source:www.DrGlass.org)