Clinical study on lateral plating versus posterolateral plating for lateral malleolus fractures in the elderly
LIU Yong
CHEN Guo-chuan
YU Wei
ZHANG Fu-ning
Abstract：Objective To compare effects and complications between lateral neutralization plating and posterolateral anatomic plating for lateral malleolus fractures in the elderly. Methods A total of 44 patients were included. All were divided into 2 groups: lateral neutralization plating group; posterolateral anatomic plating group.Lateral neutralization plating group ( n = 24) : 13 males and 11 females; the mean age was ( 69.6 ± 15.8) years ( range: 60-84 years); bone mineral density of lumbar and femoral neck were ( 0.889 ± 0.104) and ( 0.675 ±0.092) g/cm2. Posterolateral anatomic plating group ( n = 20) : 12 males and 8 females; the mean age was ( 67.9 ±13.2) years ( range: 60-78 years); bone mineral density of lumbar and femoral neck were ( 0.925 ± 0.093) and ( 0.568 ± 0.062) g/cm2. The average preoperative hospital stay was 4.8 d and 4.5 d respectively. Causes of the injury:falls in 24 patients, falls during cycling in 4 and falls from stairs in 16. According to supination external rotation subtype of Lauge-Hansen classification, 7 patients had subtype II, 4 subtype III, and 33 subtype IV. Clinical outcomes and postoperative complications were analyzed by American Orthopedic Foot Ankle Society, ( AOFAS) scores.Results All patients were followed for 12-25 months ( average: 17 months). There were no significant differences in gender, age, comorbidities, supination and external rotation classification, preoperative hospital stay and femoral neck bone density between the 2 groups ( P＞ 0.05). There were no significant differences in the mean operative time and intraoperative blood loss between the 2 groups ( P = 0.29, 0.26). AOFAS: the mean score of ( 93.7 ± 6.1) in the lateral neutralization plate group, and ( 94.5 ± 6.0) in the posterolateral plating group; with no significant differences ( P = 0.38). Complications: 9 patients of incision infection and internal fixation irritation in the lateral neutralization plate group; 1 internal fixation irritation and 1 fibula tendon disease in the posterolateral plating group; with significant differences between the 2 groups ( P = 0.04). Conclusions Both procedures are effective, while posterolateral plating can reduce soft tissue complications.
Keywords：Osteoporotic fracturesAnkle fracturesFracture fixationinternal
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 196-200 )