| Objective: Ankle is the body's load-bearing joints, in their daily lives ankle vulnerable to injury, ankle fractures body about 3.92% of the total number of fractures. Tri-malleolus bone fractures is the more serious type, an intra-articular fracture, accompanied the ligament injury of joint and the dislocation of the ankle joint, treatment difficulties, ineffective, especially for a comminuted fracture of the hock, the reduction and fixation has become the medical profession's a major problem, treatment often leave after a certain degree of side effects, ranging from walking instability, while in joint deformities and traumatic arthritis, extremely joint stiffness. The current treatment of the tri-malleolus bone fractures there are two main methods: the one is plaster fixation after manual reduction; the another is open reduction and internal fixation by surgery . With the requirements of people's quality of life is raising and the development of medical technology,the treatment of surgery has became the first choose. Because of the superficial anatomical location,the relatively simple surgical methods of lateral malleolus and internal malleolus have already been mastered by the majority of clinicians; to the hock fracture, there are more methods to exposed it, but because of its anatomical location ankle is deeper, then dragging and baffling by surrounding ligaments and tendons , it is difficult to clearly exposed in the operation, especially to the case that the fracture is comminuted of the hock, because of the bone fragments are often smaller, existing fixed materials such as steel planks, screws, pinning are difficultly to fix it firmly, such as after shedding vulnerable to intra-articular loose bodies, then influencing the ankle joint function, but if all its discarded , and again greatly increase the incidence of postoperation complications, so the exposure reduction and fixation of the hock and its articular facet are often more difficult.In this paper, evaluate the effection of medical ear-brain (EC glue) to the fracture connate of osteochondra , the feasibility of aggling the crash cartilage , and application of the ankle lateral dislocation, exposure to treat the complex fractures after surgery in the treatment of ankle fractures to the advantages of improved surgical treatment, and compromise other related issues to allianceMethod:1 Experimental study part: Choose 40 adult New Zealand white rabbits were randomly divided into two groups, each of 20, all animals left knee caused part of the articular surface with bone fractures, the experimental group used purely EC glue adhesion reduction and fixation, control group of cross-pinning reduction and fixation. At the 4,6,8,12 weeks respectively every five animals were killed in each group and drew materials-bones with be carefully removed muscle specimens used for the general observation, X-ray inspection, histological observation, serum alkaline phosphatase enzymes and serum calcium levels. From the macro and micro aspects of the two observation bone healing, and statistical analysis, concluded.2 clinical study parts: observation of 40 cases since 2000,hough fracture with a comminuted one,hough fracture films account for at least 25% of the articular surface, divided into two groups of 20 cases were to open reduction internal fixation, the group A of the lateral ankle dislocation and hough exposure, and application of EC glue fixed with adhesive small articular surface of bone, and then by using absorbable screw to fix hough, in group B, according block of hough fracture displacement direction, and incision located meta-post of internal and external malleolus to reveal hough, not the articular surface with tiny bone fragments special fixed, or be removed, and then using absorbable screws or cancellous bone screw to fix the hough. Postoperative care of the ankle, gypsum fixed for six weeks, a total of 40 patients were all follow-up, an average of 14 months follow-up, according to AOFAS ankle - rearfoot score system (Association of the United States ankle surgery scoring system, a possible 100 points score), and statistical analysis of the two groups of patients were compared ankle joint function. Results:1 Experimental Study: 4,6,8,12 weeks after general observation, histological observations, X-ray imaging and serum biochemistry. Gross observation and X-ray examination impact: the experimental group: no fracture-shift, four weeks and six weeks at the fracture line blurred stump bone fracture callus formation, no EC glue residue; 8 weeks of basic fracture disappear, a large number of bone fracture callus formation ends, new bone fracture lines were filled with 12 weeks of fracture lines disappear, fracture healing. Control group: no fracture displacement, four weeks and six weeks at the fracture line blurred stump bone fracture callus formation, fixed firmly implant; eight weeks at the fracture line disappeared, and a large number of bone fractures stump callus formation, fracture lines were filled with new bone; 12 weeks at the fracture line disappeared, fracture healing. Histological observation: the experimental group: four weeks, the cartilage gradually ossified, the EC did not fully degradable before osteoblasts crawling all over, the two bone ends to the middle, at the junction of the early implantation of a dispersion of lymphocyte infiltration, eosinophils were seen by chance , disappeared at six weeks, and at 8 weeks, basically complete the restoration, new small vascular proliferation obviously, the trabecular bone arranged contiguity orderly; at 12 weeks, when fully mature bone tissue replacement, and ends no boundaries. Control group: four weeks, the cartilage gradually ossified, 8 weeks, and basically complete the restoration, new small vascular proliferation obviously, the trabecular bone arranged contiguity orderly, and 12 weeks when fully mature bone tissue replacement, and ends no boundaries. Serum biochemical examination: 4 weeks at the experimental group and control group serum calcium, alkaline phosphatase higher than the normal average level, the difference is exist in statistic between the level of alkaline; 8 weeks, the level of two groups began to decrease, but the level is higher than the normal average level,and the difference is exist in statistic between the level of alkaline; 8 weeks , the level of two groups to recover normal level.2 Clinical study parts: an average of 14 months follow-up, the group A 20 patients with osteoarthritis in one case, two cases in the group B osteoarthritis, according to AOFAS ankle - rearfoot score system, the group A scored 98 points, minimum score of 82 points, an average of 92.6 points, group B was the highest scoring 97 points, the lowest scoring 68 points, an average of 88.35 points, scores statistically, P <0.05, there is a significant difference.Conclusion:1 Binding the osteochondra fractures by EC glue is not delayed fracture healing time, the conventional material can be used in tri-malleolus bone fractures surgery.2 For the hough fracture with the smash cartilage in tri-mallelus bone fracture could be the lateral ankle dislocation of the hough exposure and arthrodial cartilage surface, the medical application of EC glue bonding with the tiny chip block with facies ossea , and then the absorbed screw fixed the hough, improving therapeutic effect.
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