A Study On The Clinical Efficacy Of A New Anatomic Locki Ng Plate For Posterior Malleolus Fracture

Objective:To investigate the clinical efficacy of the new posterior ankle anatomical 1 ocking plate in the treatment of posterior ankle,and to compare its clinical effi cacy with that of the distal radius plate in the treatment of posterior ankle frac ture.For the clinical treatment of posterior ankle fracture to provide a better ch oice of internal plants.Methods:Data of patients with ankle fractures(all the fractures involved the posterior ankle and the fracture area≥25%)admitted to the department of orthopedics of the first affiliated hospital of kunming medical university from September 2017 to December 2018 were collected.。There were a total of 22 cases,including 14 males and 8 females,aged from 21 to 57 years old,with an average age of 42.5 years.Twenty patients(11 patients with AO type B and 9 patients with type C)suffered fractures of the three ankles.Posterior malleolus fracture in 2 cases.All patients were treated with open reduction via the posterolateral approach an d internal fixation with a new posterior malleolus anatomical locking plate afte r 3 days to 7 days(mean 5 days)of deswelling until the appearance of dermato glyphic lines.A total of 35 patients were selected,including 20 patients with trip le ankle fractures fixation with posterior malleolus anatomical plate and 15 pati ents who underwent distal radius steel plate fixation for triple ankle fractures a t the same time,the patients were divided into new anatomic locking plate grou p(I group)and the distal radius plate group(IIgroup).A total of 20 cases were i ncluded in I group,12 cases were male,8 cases were female.AO classification:11 patients with type B and 9 patients with type C,aged from 25 to 57,with an average age of(43.2±8.9)years.15 cases were included inIIgroup,8 cases were m ale,and 7 cases were female.AO classification:8 patients with type B and 7 pati ents with type C,aged from 28 to 72 years,with an average age of(47.5± 13.1)y ears.All of the patients underwent a detumescence ranged 3-7 days,after ankle posterolateral approach fixed ankle fracture,35 patients were followed up.At 6 months and 12 months after surgery,ankle function was evaluated by AOFAS st andard scores for ankle and posterior foot function,ankle pain was evaluated by VSA,and ankle range of motion(ROM)was evaluated at 12months postoperativ elyResults:1.22 patients were followed up for 11 months-25 months(mean 16 months).The fracture healing time was 8 weeks-13 weeks,with an average of 11.8 weeks.There was no delayed fracture healing or fracture non-healing.1 Patient’s skin superficial infection,healing after dressing change.No traumatic osteoarthritis was found at the last follow-up.All patients were evaluated with the American society for ankle and ankle surgery’s standard score for ankle and posterior foot function:excellent in 20 cases.The excellent and good rate was 100%and the average score was 94.0All the patients were followed-up effectively,I group fixed set of ankle fra ctures time-consuming(26.4+2.6)minutes after the Ⅱ group(33.1+4.7)mi nutes short,with statistical difference(P<0.05),the average operation time of I group(1.6+0.2)h is short in comparison to II group(2.0+0.2)h,and the difference is significant(P<0.05).When followed-up at 6,12 months,there was no significa nt difference in AOFAS ankle and hindfoot scores between the two groups(P>0.05),while there was a significant difference among the members in each group(P<0.05).There were significant differences in VSA pain rating between and wit hin the two groups(P<0.05),and there was no significant difference in ankle R OM between the two groups at 12 months postoperatively(P>0.05).None of the patients displayed osteoarthritis at the last follow-up.Conclusions:The new anatomic locking plate of posterior malleolus has good curative effect in treating posterior malleolus fracture.and both internal fixation methods can achieve a favorable clinical treatment effect,but the new anatomic locking plate costs less surgical time,and the postoperative pain score is lower than that of the plate fixation of the distal radius.