Comparison of curative effects of different surgical approaches to Haraguchi type I posterior malleolus fractures
YANG Le1, LIANG Zhikong2, PEI Shouke3, LI Liang1, HU Fangyong4, WANG Changfeng1
1. Department of 0rthopaedics, 2. Department of Rehabilitation Medicine and Physiotherapy, 3. Department of Medical Image, 4. Emergency Department,Jiangsu Provincial Corps Hospital, Chinese People's Armed Police Force,Yangzhou 225002,China
Abstract：Objective To compare the efficacy of posterior direct open reduction with posterior anterior screw internal fixation and indirect closed reduction with anterior posterior screw fixation in the treatment of Haraguchi type Ⅰ posterior malleolus fractures. Methods The clinical data on patients with Haraguchi type Ⅰ ankle fractures who had undergone surgery in Jiangsu Corps Hospital of People's Armed Police Force between October 2015 and October 2018 was collected. According to surgical methods, these patients were divided into the posterior direct open reduction group (n=41) and the indirect closed reduction group (n=38). The difference in efficacy was compared between the two groups. Results There was no significant difference in the duration of surgery, intraoperative blood loss or postoperative complications between the two groups. Fluoroscopy was used more frequently in the indirect closed reduction group (8.95±0.81) than in the direct open reduction group (6.63±0.74), and the difference was statistically significant (P<0.05). According to postoperative X-ray examination, 30 cases were excellent in the direct open reduction group, and the excellent rate was 73.17%, compared with 12 cases and 31.58% in the indirect closed reduction group. The reduction quality in the direct open reduction group was significantly better than in the closed reduction group (P<0.05). After one year, fractures of patients in the two groups healed completely. After two years, the AOFA score of the direct open reduction group (87.76±2.50) was significantly higher than that of the indirect closed reduction group (82.03±3.04). Conclusions Direct posterolateral open reduction with posterior and anterior screws can achieve better reduction and fixation of Haraguchi type Ⅰ posterior malleolus fractures and better ankle function than closed reduction with anterior and posterior screws.
杨乐, 梁之孔, 裴守科, 李亮, 胡方勇, 王长峰. Haraguchi Ⅰ型后踝骨折不同术式疗效对比[J]. 武警医学, 2021, 32(12): 1013-1016.
YANG Le, LIANG Zhikong, PEI Shouke, LI Liang, HU Fangyong, WANG Changfeng. Comparison of curative effects of different surgical approaches to Haraguchi type I posterior malleolus fractures. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(12): 1013-1016.
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