A Comparative Study Of Conservative And Surgical Treatment Of The Supination-eversion Fracture And Dislocation Of Ankle

Objective:To compare the curative effect of treating the Ⅱ-Ⅳ degrees Supination-eversion Fracture and Dislocation of Ankle by open surgical and closed reduction with the external "U" type gypsum fixation, to analysis of various factors affect the treatment effects,to summarize clinical experience, to improve the curative effect and reduce the late fracture complications, to improve life quality and guide clinic treatment.Treatment:According to the diagnostic criteria, selection and exclusion standard, We treated98cases from the Orthopaedic inpatient department of the Traditional Chinese medicine hospital in jingzhou prefecture between June2010to December2011。According to the different methods of treatment, we divided them into two groups,48cases were treated with manipulative reduction and fixed with the external "U" type gypsum (group A) and50cases with open surgical (group B). There were no more obvious differences in the sex,age and the fracture type points between the two groups preoperative (P>0.05). They were comparableRusults:Two grous were followed up with visits for6to12months. At the hospitalization days、treadments and callus growth, Group A was obviously less than that in group B. According to Leeds score standard comparison:There is no significant difference between the two groups in the degree Ⅱ damage (P=0.325>0.05); in the degreeⅢ and Ⅳdamage, There is obvious significant difference between the two groups (Ⅲdamage p=0.039, IVdamage p=0.042, P<0.05), Group B is better than group A. According to Mazur score standard comparison: There is no significant difference between the two groups in the degree Ⅱ damage (t=0.518, p=0.608>0.01); in the degreeⅢand IV damage, There is obvious significant difference between the two groups (Ⅲdamage t=4.148, p=0.000<0.01:IVdamage t=6.76, p=0.001,0.01), Group B is better than group A.Conclusion:At the Ⅱ type and part of the Ⅲ type that has no obvious posterior malleolar fracture orposterior malleolar fractures with defects Less than10%of the articular surface, compared with surgical treatment,conservative treatment has no obvious difference in the restore of Ankle function,and more advantageous for callus growth. For the IV type and part of the III type that has posterior malleolar fractures with the injured articular surface of above10%, it is hard to manipulative reduction, suggest taking surgical treatment.