| Objective To compare and analysis the efficiency of posterior malleolus fractures by internal fixation via percutaneous cannulated screw fixation and posterolateral approach.Methods Collecting52patients that suffered from trimalleolar fracture:We collect52patients with trimalleolar fracture who hospitalize in our hospital from2012-3to2013-3,all patients came with posterior malleolus.31patients were percutaneous cannulated screw fixation,and21were fixed via posterolateral approach.The age of patients is23-63,and average age is42,including25men and27women.All patients were typed by CT:16case of type Ⅱb,,23cases of type III,13case of type IV.We defined the31cases which were percutaneous cannulated screw fixation group A,and the other21cases group B. All cases in group A were fixed by percutaneous cannulated screw(3.0mm or4.0mm) via anterior approach,and all cases in group B were fixed by screw(3.0mm or4.0mm) or plate via posterolateral approach.Result Average operational duratio:group A,17.5min;group B,28.7min. Average bleeding volume:group A,10ml;group B,35ml.Average fluoroscopy times:group A,3.8;group B,2.6.Average surgical incision size:group A,1.3cm;group B8.4cm. All the patients were examined by CT, the result showed that,group A inadequate immobilization:13cases,including3badly performed cases(joint surface displacement>2mm after internal fixation),10poor screw direction and location cases(7cases with tibiofibular joint set in screw,including2cases that less area screw contact the fracture fragment,which result in less pull-out strength;and3cases that the angle of screw and fracture lines was<50°); Group B,3inadequate immobilization and badly performed cases.The date was analysised by SPSS software,and the result was that,the efficiency of two group was different obviously.Conclusions The reliability of posterior fracture by internal fixation via posterolateral approach was better than anterior approach.Operative efficacy of group B was better than group A. |
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