Comparison of Effect of"Anterior-to-Posterior"and"Posterior-to-Anterior"Directions During Screw Internal Fixation in the Treatment of Haraguchi Type Ⅰ Posterior Malleolar Fractures
WANG Li
LI Maoshan
LI Deng
Abstract：Objective To explore and compare the effect of"anterior-to-posterior"and"posterior-to-anterior"directions during screw internal fixation in the treatment of Haraguchi type I posterior malleolar fractures.Methods Retrospective analysis was performed on the data of patients with Haraguchi typeⅠposterior malleolus fractures admitted to department of orthopedics of the Third People's Hospital of Henan Province,and the patients were divided into two groups according to surgical treatment regimens.The patients with closed reduction"anterior-to-posterior"hollow screw fixation were selected as control group,and the patients with posteriorlateral approach"posterior-to-anterior"hollow screw fixation were included in observation group.By the propensity matching scoring method,52 pairs of case data with no statistically significant differences in baseline were finally obtained.The surgical time,fracture healing time and full weight-bearing time were compared between the two groups,and postoperative ankle reduction effect and postoperative complications were evaluated in both groups.Changes in ankle function[American Orthopedic Foot and Ankle Society(AOFAS)ankle and posterior foot score]were compared between both groups before surgery and at the last follow-up at 6 months after surgery.Results The surgical time,fracture healing time and full weight-bearing time in observation group were significantly shortened compared with those in control group(P＜0.05).The excellent and good rate of ankle reduction in observation group(90.38%)was higher than that in control group(73.08%)(P＜0.05).There was no difference in the postoperative complication between the two groups(P＞0.05),and all cases achieved primary healing.At 6 months after surgery,the scores of pain,joint range of motion,joint stability and foot alignment and total score of AOFAS ankle and hind foot scoring system in both groups were improved compared with those before surgery(P＜0.05),and the scores in observation group were higher than those in control group except for foot alignment score(P＜0.05).Conclusion Compared with closed reduction"anterior-to-posterior"hollow screw fixation,although posteriorlateral approach"posterior-to-anterior"hollow screw fixation can prolong the surgical time in the treatment of Haraguchi type I posterior malleolus fractures,improve the postoperative long-term ankle function,but it does not significantly change the fracture healing time and full weight-bearing time,and does not increase the postoperative complications rate.
Keywords：screw internal fixation"anterior-to-posterior"screw"posterior-to-anterior"screwHaraguchi type Ⅰposterior ankle fractures
Publication Date：2023-12-15
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 4289-4293 )