Comparison of curative effects of different surgical approaches to Haraguchi type I posterior malleolus fractures

YANG Le; LIANG Zhikong; PEI Shouke; LI Liang; HU Fangyong; WANG Changfeng

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Medical Journal of the Chinese People Armed Police Forces ›› 2021, Vol. 32 ›› Issue (12) : 1013-1016.

ORIGINAL ARTICLES

Comparison of curative effects of different surgical approaches to Haraguchi type I posterior malleolus fractures

YANG Le¹, LIANG Zhikong², PEI Shouke³, LI Liang¹, HU Fangyong⁴, WANG Changfeng¹

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Abstract

Objective To compare the efficacy of posterior direct open reduction with posterior anterior screw internal fixation and indirect closed reduction with anterior posterior screw fixation in the treatment of Haraguchi type Ⅰ posterior malleolus fractures. Methods The clinical data on patients with Haraguchi type Ⅰ ankle fractures who had undergone surgery in Jiangsu Corps Hospital of People's Armed Police Force between October 2015 and October 2018 was collected. According to surgical methods, these patients were divided into the posterior direct open reduction group (n=41) and the indirect closed reduction group (n=38). The difference in efficacy was compared between the two groups. Results There was no significant difference in the duration of surgery, intraoperative blood loss or postoperative complications between the two groups. Fluoroscopy was used more frequently in the indirect closed reduction group (8.95±0.81) than in the direct open reduction group (6.63±0.74), and the difference was statistically significant (P<0.05). According to postoperative X-ray examination, 30 cases were excellent in the direct open reduction group, and the excellent rate was 73.17%, compared with 12 cases and 31.58% in the indirect closed reduction group. The reduction quality in the direct open reduction group was significantly better than in the closed reduction group (P<0.05). After one year, fractures of patients in the two groups healed completely. After two years, the AOFA score of the direct open reduction group (87.76±2.50) was significantly higher than that of the indirect closed reduction group (82.03±3.04). Conclusions Direct posterolateral open reduction with posterior and anterior screws can achieve better reduction and fixation of Haraguchi type Ⅰ posterior malleolus fractures and better ankle function than closed reduction with anterior and posterior screws.

Key words

posterior malleolus fractures / direct open reduction / indirect closed reduction / cannulated compression screws

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YANG Le, LIANG Zhikong, PEI Shouke, LI Liang, HU Fangyong, WANG Changfeng. Comparison of curative effects of different surgical approaches to Haraguchi type I posterior malleolus fractures[J]. Medical Journal of the Chinese People Armed Police Forces. 2021, 32(12): 1013-1016

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