COMPARATIVE DESCRIPTION OF THE DANIS-WEBER, AO, LAUGE HANSEN AND DIAS-TACHDJIAN CLASSIFICATION SYSTEMS FOR ANKLE FRACTURES

Bryam Esteban Coello García, Byron Fabián Pinos Reyes, Genesis Brigeth Jaramillo Curipoma, Fernanda Gisella Diaz Araujo, Andrea Verónica Reinoso Piedra, Maria Jose Montero Cardenas, José Miguel Guerrero Granda, Diego Javier Sánchez Pulgarín, Carmen Ruth Sanmartín Riera, Karina Alexandra Bermeo Bermeo
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Abstract

Introduction: Ankle fractures are very common in emergency departments around the world. Through time and scientific advances, several means of classification have been structured with regard to ankle fractures. The most frequent, recognized and used classification systems in ankle fractures at the moment are those of Lauge-Hansen, the AO/OTA system, Danis-Weber in adults and Dias-Tachjian in pediatrics. Objective: to detail the current information related to the Danis-Weber, AO, Lauge-Hansen and Dias-Tachdjian classification systems for ankle fractures. Methodology: a total of 37 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 24 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: ankle fracture classification, AO classification, Danis-Weber classification, Lauge Hansen classification and Dias-Tachdjian classification. Results: In day-to-day clinical practice, the fracture itself is usually descriptively classified as a uni-, bi- or trimalleolar fracture. In the Lauge and Hanssen system, supination-adduction ranges from 10 to 20%, supination-external rotation ranges from 40% to 75%, pronation-abduction ranges from 5% to 20% and pronation-external rotation accounts for 5% to 20% of malleolar fractures. The Dias-Tachdjian system shows that supination injuries are more frequent than pronation injuries, accounting for up to 82% of all ankle fractures, with supination-inversion being the most common, accounting for about 61% of all pediatric ankle fractures. With regard to the AO/OTA classification, the most common infrasyndromal fractures are A1 (isolated): 68.9%, followed by A2 (bimalleolar): 24.8% and finally A3 (trimalleolar): 6.3%. Trans-ankle fractures account for 85% of ankle fractures. Suprasyndesmal fractures are type C of the Weber classification and following the AO/OTA classification, type 44C1 would be the most common (5.3%). Conclusions: the importance of fracture classification systems is crucial in the choice of treatment, both conservative and surgical, as well as in the future prognosis of the affected individual. The most frequent, recognized and used classification systems in ankle fractures at the moment are those of Lauge-Hansen, the AO/OTA system, Danis-Weber in adults and Dias-Tachjian in pediatrics. In addition to the classification systems cited in this article, there are others, which may have relevance depending on the individual situation. It is important to emphasize that most of the classifications are based on a complementary study, such as radiographs or others, so knowing how to order the appropriate study and incidences helps in the future treatment of the patient with the aim of a speedy recovery. KEY WORDS: classification, fractures, ankle, systems, trauma.
丹尼斯-韦伯、奥、劳格-汉森和迪亚斯-塔奇吉安踝关节骨折分类系统的比较说明
简介踝关节骨折在世界各地的急诊科都很常见。随着时间的推移和科学的进步,针对踝关节骨折已经形成了多种分类方法。目前在踝关节骨折方面最常见、最受认可和最常用的分类系统是劳格-汉森(Lauge-Hansen)系统、AO/OTA 系统、成人的达尼斯-韦伯(Danis-Weber)系统和儿科的迪亚斯-塔奇江(Dias-Tachdjian)系统。目的:详细介绍与踝关节骨折的达尼斯-韦伯(Danis-Weber)系统、AO 系统、劳格-汉森(Lauge-Hansen)系统和迪亚斯-塔奇江(Dias-Tachdjian)系统有关的最新信息。方法:本综述共分析了 37 篇文章,包括综述性文章、原创性文章以及临床病例,其中有 24 篇参考书目,因为其他文章与本研究无关。信息来源于PubMed、Google Scholar和Cochrane;搜索西班牙文、葡萄牙文和英文信息时使用的术语为:踝关节骨折分类、AO分类、Danis-Weber分类、Lauge Hansen分类和Dias-Tachdjian分类:在日常临床实践中,骨折本身通常被描述性地划分为单极、双极或三极骨折。在劳格-汉森系统中,上举-内收占 10%至 20%,上举-外旋占 40%至 75%,前伸-内收占 5%至 20%,前伸-外旋占 5%至 20%。Dias-Tachdjian系统显示,上翻损伤比前翻损伤更常见,占所有踝关节骨折的82%,其中上翻内翻最常见,约占所有小儿踝关节骨折的61%。根据 AO/OTA 分类,最常见的踝下骨折是 A1(孤立性):占 68.9%,其次是 A2(双踝骨折),占 24.8%,最后是 A3(小踝骨折):24.8%,最后是 A3(三极):6.3%.跨踝关节骨折占踝关节骨折的 85%。结论:骨折分类系统对于选择保守治疗和手术治疗以及患者未来的预后至关重要。目前在踝关节骨折中最常见、最公认和最常用的分类系统是劳格-汉森(Lauge-Hansen)系统、AO/OTA 系统、成人的达尼斯-韦伯(Danis-Weber)系统和儿科的迪亚斯-塔奇安(Dias-Tachjian)系统。除本文引用的分类系统外,还有其他一些分类系统,根据具体情况可能会有相关性。需要强调的是,大多数分类方法都是基于辅助检查,如放射影像学检查或其他检查,因此,了解如何选择适当的检查方法和发病率有助于患者今后的治疗,从而达到快速康复的目的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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