Comparison Of The Clinical Results Of Posterior Malleolus Fracture Treated By Posterior Medial Approach And Posterolateral Approach

Objectives: To compare the clinical results of posteromedial approach and posterolateral approach in the treatment of posterior malleolar for trimalleolar fractures.Method:Twenty adult patients with unstable trimalleolar fractures who were treated from March 2018 to March 2019 were selected as observation objects.Among them,12 cases were treated with traditional posterolateral approach for posterior ankle fractures,and 8 cases were treated with posterior medial approach for posterior ankle fractures.Follow-up was used to compare the operation time,bleeding volume,fracture healing time,infection rate of the two methods,Olerud-Molander score and Baird score.Result:All patients were followed up for 12-24 months,and no infection occurred.The average operation time was 53.63 minutes in the postero-medial group and 64.83 minutes in the postero-lateral group.The average intraoperative blood loss was 312.50 ml in postero-medial group and 354.17 ml in postero-lateral group.Fracture healing time was 12-24 weeks in both groups,with no significant difference.There was also no significant difference in Olerud-Molander score at the last follow-up or Baird score.Conclusion:Compared with the posterolateral approach,the postero-medial approach for the treatment of posterior ankle fractures in trimalleolar fractures has no significant difference in long-term effect,and could also achieve a good prognosis.However,since the postero-medial approach can avoid the change of body position in the traditional approach,it can save the operation time and reduce the amount of bleeding.For patients with posterior ankle fractures that are close to the medial malleolus or even spread to the medial malleolus,the postero-medial approach is more convenient to expose and fix the posterior malleolus.