目的 总结不同踝关节骨折分型 的CT表现及特点。方法 回顾性分析2016 年7月-2018年7月我院收治的22例踝关节 骨折患者的临床资料。所有患者术前经X 线检查确诊分型，并接受CT检查。选取踝 穴近端1cm水平CT横断面图像，对DanisWeber骨折分型各亚型数量和各种CT图像 数量进行统计，分析两者相关性。结果 以a、b、c代表腓骨骨折、后踝骨折、骨 间韧带(IOL)断裂，22例踝关节骨折的CT 图像可归纳为以下8类：0度3例，腓骨、 后踝、IOL3个结构均完整；Ⅰa类1例， 腓骨骨折、后踝完整、IOL完整；Ⅰb类 1例，腓骨完整、后踝骨折、IOL完整； Ⅰc类3例，腓骨完整、后踝完整、IOL断 裂；Ⅱab类7例，腓骨骨折、后踝骨折、 IOL完整；Ⅱac类3例，腓骨骨折、后踝完 整、IOL断裂；Ⅱbc类2例，腓骨完整、后 踝骨折、IOL断裂；Ⅲ度2例，a、b、c3处 均损伤。CT图像显示，IOL断裂发生率随 Danis-Weber分型严重程度增高而升高， 经秩相关检验可知两者具有显著相关性 (Spearman R=0.797，P﹤0.001)。结论 踝 穴近端1cm水平CT横断面图像可于术前准 确判断下胫腓联合IOL的损伤情况，且与 Danis-Weber骨折分型有一定相关性，能 发现X线漏诊情况。

Objective To summarize the CT findings and features of ankle joints with different fracture classification. Methods The clinical data of 22 patients with ankle fractures admitted to our hospital from July 2016 to July 2018 were analyzed retrospectively. All patients were diagnosed and classified by X-ray before surgery and given CT examination. The horizontal CT cross-sectional image at 1cm of ankle mortise near-end was selected, and the number of subtypes of Danis-Weber fracture classification and the number of various CT images were counted, and the correlation between the two method was analyzed. Results The a, b and c referred to fibular fracture, posterior malleolar fracture and interosseous ligament (IOL) fracture, and the CT images of 22 cases of ankle fractures could be summarized into the following 8 categories: 0 degrees in 3 cases (complete structures of fibula, posterior malleolus and IOL), Ia type in 1 case (fibular fracture, complete posterior malleolus, complete IOL), Ib type in 1 case (complete fibula, posterior malleolar fracture, complete IOL), Ic type in 3 cases (complete fibula, complete posterior malleolus, IOL fracture), IIab type in 7 cases (fibular fracture, posterior malleolar fracture and complete IOL), IIac type in 3 cases (fibular fracture, complete posterior malleolus, IOL fracture), IIbc type in 2 cases (complete fibula, posterior malleolar fracture, IOL fracture) and III type in 2 cases (a, b, and c fractures). CT images showed that the incidence rated of IOL fracture was increased with the severity of Danis-Weber classification, and the rank correlation test showed that there was a significant correlation between the two method(Spearman R=0.797, P<0.001). Conclusion CT cross-sectional image at 1cm of ankle mortise near-end can accurately determine the injury of tibiofibula combined with IOL before operation, and it has correlation with the Danis-Weber fracture classification, and it helps to find the missed diagnosis of X-ray.