[Objective]To compare clinical efficacy of supramalleolar osteotomy(SMOT)with plate internal fixation(IF)versus external fixation(EF)by distracting Ilizarov frame for traumatic ankle varus deformity(TAVD)in adolescents.[Methods]A retrospective analysis was performed on 30 adolescent patients with TAVD treated in our hospital from February 2015 to February 2022.According to doctor-pa-tient communication,16 patients had SMOT with IF of anatomical plate,while other 14 patients were treated with SMOT with EF of distract-ing Ilizarov frame.The perioperative,follow-up and imaging data of the two groups were compared.[Results]The IF group proved signifi-cantly superior to the EF group in terms of operation time[(90.0±11.6)min vs(102.1±9.1)min,P=0.004]and hospital stay[(13.3±4.4)days vs(18.5±5.3)days,P=0.007],whereas significantly inferior to the EF group in terms of intraoperative blood loss[(156.9±46.7)ml vs(90.7± 14.4)ml,P＜0.001],total incision length[(14.5±2.3)cm vs(4.6±0.8)cm,P＜0.001],and postoperative ambulation time[(71.7±16.7)days vs(5.6±2.3)days,P＜0.001].The mean follow-up period lasted for(20.6±3.5)months on an average,and the VAS and AOFAS scores in both groups were significantly improved over time(P＜0.05).Morever,the IF proved significantly better than the EF group regarding VAS score 6 months postoperatively[(1.3±1.3)vs(2.6±1.6),P=0.023].Regarding image,talus title(TT),tibial anterior surface angle(TAS),and Takakura scale were significantly improved in both groups after surgery compared with those preoperatively(P＜0.05).The IF group was significantly superior to the EF group in terms of TAS[(89.8±1.4)° vs(87.6±3.4)°,P=0.036]and Takakura grade[0/Ⅰ/Ⅱ/Ⅲa/Ⅲb/Ⅳ,(2/11/3/0/0/0)vs(0/7/6/1/0/0),P=0.038]3 months after surgery.[Conclusion]Both fixation methods in SMOT are effective in the treatment of juvenile TAVD.Compared with internal fixation,the external fixation has advantages of less surgical trauma,less bleeding,early weight-bearing activities,avoiding bone grafting,etc.,whereas it has disadvantages such as longer operation time,longer hospital stay,more intraoperative fluoroscopy,and greater pain for patients.
NETL
NSTL
万方数据
