Two Kinds Of Method To Treat Type B Ankle Fractures 60 Cases Clinical Observation

Objective:this paper aims to objectively analyze the advantages and disadvantages of internal fixation for open reduction by steel plate screw and external fixation for closed reduction by splint on the treatment of type B ankle fracture through clinical observation. This paper analyzes all elements influencing curative effects, summarizes experience, improves curative effect, reduces complication, improves patients'quality of life and guides the clinical treatment.Methods:all patients were from the outpatient buildings and the inpatient buildings of department of ankle traumatology under Sichuan Orthopaedic Hospital and orthopedic surgery department under Tianquan Hospital of Traditional Chinese Medicine. From June,2009 to October,2010, according to diagnostic standard, inclusion standard and exclusion standard of medical case,60 cases (60ankle) with type B ankle fractures were selected and divided into two groups based on fixation: group A including 30 cases (8 cases with type B1,1leases with type B2 and 11 cases with type B3) adopted internal fixation group for open reduction by steel plate screw; group B including 30 cases (12 cases with type B1,10 cases with type B2 and 8 cases with type B3) adopted external fixation for closed reduction by splint. There was comparability between the two groups since no obvious difference could be found in accordance with four indexes such as patient gender, age structure, and postoperative X-ray and AO classification. Follow-up visits to all patients were be implemented after the treatment within 6 to 10 months, and the average time was 7.8months. Through clinical observation, postoperative X-ray and function scores of the two groups of patients, statistic analysis should be made to analyze and evaluate the curative effect of the two treatments.Results:both internal fixation group for open reduction by steel plate screw and external fixation group for closed reduction by splint were effective in the treatment of type B1B2 ankle fractures, and the rates are respectively up to 100%,90.9%and 100%,83.3%, and there is no significant statistical difference between the contrast of postoperative X-ray and ankle function score (P>0.05). External fixation group for closed reduction by splint had a less effective treatment on type B3 ankle fractures, and the rate is 25%, which is lower than 81.8% of internal fixation group for open reduction by steel plate screw; there is statistical difference between the contrast of ankle function scores (P<0.05), significant statistical difference on the postoperative X-ray can be found (P<0.05).Conclusion:When type B ankle fractures are properly reset and effectively fixed, both external fixation group for closed reduction by splint and internal fixation group for open reduction by steel plate screw on type B1B2 ankle fractures can obtain good curative effect, and its excellent rate reaches to 83%. but external fixation for closed reduction by splint had a less effective treatment on type B3 ankle fractures than internal fixation for open reduction by steel plate screw, because it is difficult to make effective external fixation after the ankle was reset, and the fact that manipulative reduction and plywood adjustment should be repeated would also affect the curative effect, therefore, clinical treatment on type B1B2 ankle fractures shall be selected according to patients'specific situations and requirements of ankle functions. Selection of the two treatment methods has no obvious impact on short-term curative effect and functional recovery of the ankle fractures. For type B3ankle fractures, internal fixation for open reduction by steel plate screw is recommended, what's more, no matter whether the posterior malleolus fracture is less than one fourth or not, it shall be fixed.