A Comparison Of The Locking Compressiom Plate With The Cannulated Screw Fixation In The Treatment Of The Osteoporosis Posterior Malleolus Fractures

Objective:To explore the clinical effect for the osteoporosis posterior malleolusfracture by comparing open reduction and cannulated screw fixation groups to openreduction and locking compressiom plate groups.Materials and methods: From March2007to August2013，51cases of senileosteoporosis complicated with fracture of posterior malleolus and clinical data wereretrospectively analyzed (bone mineral density in SD<-2.5), According to different typesof fractures, according to Lauge-Hansen classification into supination external rotationgroup and pronation-external rotation group, each further divided into the cannulated screwfixation group and the locking plate fixation group. Supination external rotation groupconsisted of28patients, including11males and17females; aged55to76years, average61.2years; among which16patients cannulated screw locking plate group12cases.Pronation-external rotation group consisted of23patients, including9males and14females; aged55to78years, average63.3years,13cases in the cannulated screw fixationgroup,10cases of the locking compressiom plate group.Comparison of two groups ofpatients with operation time, blood loss, postoperative VAS pain score, complications andat the last follow-up, according to Olerud and Molander ankle function score.Results:28cases were an average of11.5months (9-18months) follow-up, allfractures healed; In the locking compressiom plate groups,1patients were lost tofollow-up,23patients received an average of12.3months (9~18months) follow-up.2cases with fracture of lateral malleolus incision appears red, skin flap necrosis, platepartially exposed, by dressing the wound healing after drying, the fixation of woundhealing after fracture; no deep infection;0cases nonunion. Comparison of the lockingcompressiom plate groups and the hollow nail group in the operation time, blood loss,postoperative VAS pain scores, no significant difference in postoperative complications, score function.The locking plate groups were significantly better than the cannulated screwfixation groups. The differences were statistically significant (P<0.05).Conclusion: Operation method of locking plate fixation in the treatment of senileosteoporotic fracture of posterior malleolus for ankle joint stability, early joint exercise andthe function of ankle joint, locking plate fixation is superior to the cannulated screwfixation.