Surgical Treatment of Ankle Fracture with Posterior Malleolus Involved

Abstract：Objective To investigate the mechanism of the injury,surgical treatment and the outcome of the anklebone fracture extended to posterior malleolus. Methods Between July 2008 to March 2012,42 patients with posterior malleolus fractures were surgical treated,including 30 males and 12 females. Fracture were classified with Lauge_Hansen classification system;supination_external rotation,pronation_external and pronation_abduction rotation accounted for 21,12 and 9 cases. Ac_cording to CT scan classification,the group was made up of 22 typeⅠ cases,12 typeⅡand 8 type Ⅲ cases. Internal fixation were accomplished by buttress plate and / or multiple_canulated screws which was decided upon the severity of osteochondral fragment impaction at posterior tibial platform. Results The postoperative follow_up period was 12 to 24 months. All the inci_sions were healed uneventfully,and fractures were healed in 10 to 18 weeks postoperatively. According to American Orthopae_dic Foot and Ankle Society(AOFAS),the results of ankle and hindfoot score were excellent in 21 cases,good in 15,and fair in 6 with an excellent and good rate of 85. 7% . Conclusion Anklebone fracture extended to posterior malleolus is combined with the impaction of posteromedial tibial plafond and ankle joint disassociation. According to different types of posterior malleolus fractures of ankle joint,the best treatment and fixation methods will be chosen. The open reduction and internal fixation can en_sure anatomic joint restoration and union for the posterior malleolus fractures of ankle joint,and achieve most satisfied kinemat_ics function of the ankle joint.