Comparative study on fibula approach and posterolateral approach in the treatment of grade Ⅲ,Ⅳ supination-eversion ankle fractures

ZHOU Yan; MING Jiang-hua; LI Ya-ming; CHEN Qing; DENG Ming; HU Ge-liang; LIAO Qi; LIU Shi-qing

doi:10.3969/j.issn.1009-4237.2017.05.006

Abstract：Objective To compare the clinical efficacy and complications of fibula approach and posterolateral approach in the treatment of grade Ⅲ,Ⅳ supination-eversion ankle fractures. Methods Data of 56 patients with grade Ⅲ,Ⅳ supination-eversion ankle fractures from Jun.2006 to Jun.2012 was retrospectively analyzed.Nineteen cases were treated with fibula approach and 37 cases with posterolateral approach,and the fractures were fixed with plates and screws.The surgical parameters,ankle function and complications in the two groups were compared and analyzed. Results All patients were followed up for an average of 22 months (range,12-48 months),and all the fractures healed after surgery.The operative time,blood loss and hospital stay between the two groups had no significant difference(P>0.05).The average healing time was (7.6±1.2) weeks in fibula approach group and (6.3±0.7) weeks in posterolateral approach group,respectively,and the difference was statistically significant (P<0.05).At the final follow-up,the AOFAS ankle and hindfoot function score was (81.4±6.5) points in fibula approach group with excellent in 6 cases,good in 10 cases,fair in 3 cases,and the excellent and good rate was 84.2%.In posterolateral approach group, the score was (92.6±7.3) points with excellent in 22 cases,good in 13 cases,fair in 2 cases,and the excellent and good rate was 94.6%.Three cases walked with ankle pain in the fibula group. Conclusion Compared to the fibula approach, the posterolateral approach has shorter postoperative recovery period and better clinical efficacy.It is an ideal surgical approach in the treatment of grade Ⅲ,Ⅳ supination-eversion ankle fractures.