[Objective]To compare the clinical outcomes of posterior-anterior lag screw versus buttress plate for fixation of Haraguchi type Ⅰ posterior malleolus fractures.[Methods]A retrospective analysis was performed on 80 patients who received open reduction and in-ternal fixation(ORIF)for Haraguchi type Ⅰ posterior malleolus fractures from June 2020 to September 2022.According to the doctor-pa-tient communication,38 case had the posterior malleolus fractures fixed with the posterior-anterior lag screw(the screw group).while other 42 cases were fixed with buttress plate(the plate group),with the combined lateral and medial malleolar fractures treated simultaneously.The perioperative,follow-up and imaging data of the two groups were compared.[Results]The screw group was significantly less than the plate group in terms of operative time[(69.5±4.6)min vs(90.2±6.4)min,P＜0.001],total incision length[(9.0±2.3)cm vs(10.3±2.6)cm,P=0.021]and intraoperative blood loss[(104.8±20.5)ml vs(116.0±21.3)ml,P=0.019],although the former resumed postoperative walking sig-nificantly later than the latter[(64.8±3.7)days vs(60.0±4.0)days,P=0.019].There was no statistically significant difference in time to re-gain the full weight-bearing activity between the two groups(P＞0.05).Compared with those 3 months after surgery,the VAS,AOFAS scores and dorsal-plantar flexion ROM in both groups were significantly improved at the last follow-up(P＜0.05).The screw group got sig-nificantly lower AOFAS score than the plate group 3 months after surgery[(83.6±4.9)vs(86.0±5.5),P=0.044],whereas there were no signifi-cant differences in VAS score and ankle-dorsal-plantar flexion ROM between the two groups(P＞0.05).At the last follow-up,there was no significant difference between the two groups in terms of any items abovementioned(P＞0.05).As for imaging,there were no significant dif-ferences in the quality of fracture reduction and healing time between the two groups(P＞0.05).[Conclusion]Both posterior-anterior lag screw and buttress plate achieve comparable clinical consequences for fixation of Haraguchi type Ⅰ posterior malleolus fractures.By compar-ison,the screw has shorter operation time and less intraoperative bleeding,but longer time to resume walking.
Haraguchi type Ⅰ posterior malleolus fracturesposterior-anterior lag screwbuttress plateclinical outcome
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