[Objective]To compare the clinical efficacy of cannulated screw fixation versus support plate fixation of the posterior malle-olar fracture fragment in the trimalleolar fractures.[Methods]A retrospective study was done on 68 patients who received surgical treat-ment for trimalleolar fractures from February 2018 to February 2021.According to the surgeon-patient communication,41 patients had the posterior malleolus fragment fixed with cannulated screws(CS),while the other 27 patients were fixed with support plates(SP).The data re-garding to perioperative period,follow-up and images were compared between the two groups.[Results]There were no significant differenc-es in terms of operation time,incision length,intraoperative blood loss,intraoperative fluoroscopy times,incision healing grade,hospital stay,walking time,occurrences of incision infection and thrombosis events between the two groups(P＞0.05).However,the CS group proved significantly superior to the SP group in terms of incidence of toe flexion contracture[case(％),2(4.9)vs 7(25.9),P=0.012]and implant irri-tation[case(％),3(7.3)vs 11(40.7),P＜0.001].Compared with those 3 months after surgery,the VAS score,AOFAS score and ankle-dorsi-flexion/plantar flexion ROM in both groups were significantly improved at the last follow-up(P＜0.05),whereas which were not statistically significant at any corresponding time points between the two groups(P＞0.05).Radiographically,there were no statistically significant differ-ences in the quality of fracture reduction,bone healing and traumatic arthritis between the two groups(P＞0.05).The tibiofibular clear space(TFCS)and medial clear space(MCS)in both groups were significantly decreased at the last follow-up compared with those preoperatively(P＞0.05),while there were no significant differences in TFCS and MCS between the two groups at corresponding time points(P＞0.05).[Conclusion]Both cannulated screws and support plates do effectively fix posterior malleolus fracture,and achieve satisfactory clinical con-sequences,despite that the progression of post-traumatic arthritis needs to be furtherly followed up.Compared with support plate fixation,cannulated screw fixation is simpler and more effective,with fewer implant-related complications.
trimalleolar fracturesposterior malleolus fractureopen reduction and internal fixationcannulated screwplate
NETL
NSTL
万方数据
