Operative treatment of the old trimaleolus fractures
- VernacularTitle:陈旧性三踝骨折的手术治疗
- Author:
Xiang XIAO
;
Tieliang ZHANG
;
Jianguo ZHANG
- Publication Type:Journal Article
- Keywords:
Ankle joint;
Fractures;
Surgical procedures, operative
- From:
Chinese Journal of Orthopaedics
2001;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the operative methods of open reduction and fixation for the old trimalleolus fractures. Methods Fifty-eight patients of the old trimalleolus fractures were treated from January 2000 to January 2004. There are 41 males and 17 females with an average age of 43 years (ranged from 19 to 61 years). The average time of postinjury was 48 days (ranged from 29-76 days). The fractures were classified by Lauge-Hansen system. Supination-external rotation type in 37 cases. Pronation-external rotation type in 21 cases. The anterior-medial approach and anterior-lateral approach were chosen. Explore the original fracture line of medial and lateral malleolus sharply, resect scar tissue at the fagment and ankle mortise, make the ankle joint valgus, expose the posterior malleolus fragment directly and explore the original fracture line. Reducted and fixed the posterior malleolus. According to the fibular crest, the normal length and alignment were recovered. The fracture was fixed with 1/3 tubular plate or ordinary plate. Medial malleolus was fixed with screw or tention band. The time of partial weight bearing was 10-12 weeks. Results The mean duration of follow up was 37 months (range from 18-65 months). Superficial skin necrosis was in 2 cases. The wound delayed union in 4 cases. The average time of fracture healing was 25 weeks(range from 21-29 weeks). The fibula malalignment in 2 cases. 6 cases developed arthrosis. 2 cases in this 6 patients had a good reduction of fractures. The average time of the operation in this 6 patients was 58.5 d after injury. According to the AOFAS scoring system, excellent in 31 cases, good in 22 cases, fair in 5 cases. The total rate of good results was 91.4%. The pain score was up to 20 in 5 cases. 9 cases had restriction of dorsiflexion with less than 10?. Conclusion The excellent reduction and clinical results were obtained by explore the original fracture line sharply, reduct posterior malleolus fragment directly and maintain normal length of the fibula, rotation and alignment for the old trimaleolus fractures which injuried within 76 days.
