Treatment of Type Ⅳ Posterior Malleolus Fractures of Ankle with Supination-External Rotation

Abstract：Objective To evaluate the treatment for typeⅣposterior malleolus fractures of ankle with supination-eversion via the posterolateral approach. Methods Between January 2009 to June 2013,32 patients with type Ⅳ posterior malleolar fractures of ankle with supination-external rotation were treated. The fracturement were fixed with lag screw by the posterolateral approach,including 17 males and 15 females,aged from 20 to 60 years(mean 35. 62 years). The patients were followed in out-patient clinic. The fracture healing and ankle function were observed by the X-ray examinations postoperatively. Ankle joint function was evaluated according AOFAS. Results All patients got follow-up visit for at least 10 months( from 10 to 35 months,mean 12 months). The incisions of all the patients achieved primary healing. Postoperative radiograph showed bone u-nion in all the patients,at 3 to 5 months(3. 5 months on avarege). In the period of follow-up,there was no displacement,loose-ning or breakage of internal fixation. At the final follow-up,according to AOFAS scoring system,there was excellent in 17 ca-ses,good in 13 cases,fair in 2 cases with an excellent and good rate of 87. 5%. Conclusion Fixed with lag screw via the pos-terolateral approach can achieve the satisfactory results in the treatment of type Ⅳ posterior malleolus fractures of ankle with supination-eversion. The lag screw via posterolateral approach has characteristics of good surgical exposure,accurate fracture reduction and stable fixation.