Abstract:Objective To compare the efficacy of internal fixation with the lateral neutral plate and posterolateral anti-slip plate respectively in the treatment of Danis-Weber/AO type B closed lateral malleolus fractures.Methods Forty-four patients with Danis-Weber/AO type B closed lateral malleolus fractures admitted to hospital between March 2012 and June 2015 were selected and divided into the lateral neutral plate fixation group (neutral group, n=24) and the posterolateral anti-slip plate fixation group (anti-slip group, n=20) according to their willingness. In the neutral group, fractures were anatomically reduced, and appropriate lag screws were placed from the front to the back perpendicularly to the fracture line. The anatomic plate of the lateral fibula was fixed in an appropriate position on the lateral fibula. Anatomic reduction was performed in the anti-slip group. The plates were placed on the posterolateral side of the fibula, and internal fixation was performed with appropriate screws. The minimum follow-up was one year. One year after operation, functional evaluation was conducted according to the American Association of Foot and Ankle Surgeons posterior foot and ankle scoring system (AOFAS), and complications were recorded.Results AOFAS scores of the two groups were 93.7±6.1(neutral group ) and 94.5±6.0 (anti-slip group) respectively one year after operation. There was no statistically significant difference between the two groups (P=0.37).Complications occurred in seven cases (29.3%) in the neutral group, and in three cases (15.0%) in the anti-slip group, including one case of peroneal tendon disease. There was no statistically significant difference in the incidence of complications between the two groups (P=0.31).Conclusion During surgical treatment of Danis-Weber /AO type B lateral malleolus fractures with supination-external rotation type injury, the therapeutic effect of the traditional lateral plate fixation technique and the anti-slip plates is comparable, and the incidence of complications is low. Both approaches are safe and effective.
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