Abstract
The present study retrospectively reviewed the clinical efficacy of open reduction
and internal fixation with buttress plates and cannulated screws via a posterolateral
approach for the treatment of large posterior malleolus fractures. From July 2009
to April 2012, 34 patients (15 males and 19 females; mean age 41.2 years) with posterior
malleolus fractures involving >25% of the distal articular tibia, were treated by
cannulated screw and buttress plate fixation. All the patients were followed for ≥24 months.
The outcome measures included the radiographic appearance of the reduction and bone
union and the Baird-Jackson score. The average operation time was 105.6 (range 78
to 145) minutes. Radiologic examination showed all fractures achieved anatomic reduction
and primary bone union at a mean of 3.8 (range 3 to 7) months after surgery. After
an average follow-up period of 32.7 (range 24 to 44) months, no displacement, loosening,
or breakage of internal fixation was observed. However, mild posttraumatic arthritis
was present in 3 patients. According to the Baird-Jackson scoring system, the outcomes
were rated as excellent in 11 cases, good in 17, fair in 5, and poor in only 1 case,
for an excellent and good rate of 82.3%. An association analysis indicated age and
injury mechanism might be factors influencing the intraoperative and postoperative
outcomes. A posterolateral approach with buttress plate and cannulated screw internal
fixation could be an effective technique for reduction and fixation of large posterior
malleolus fragments.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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