The Comparison Of Therapeutic Effect Between The Plate And The Screws In The Treatment Of Large Posterior Malleolaor Fracture

Objective:To observe the effectiveness of the buttress plate and the screws in the treatment of posterior malleolar fracture, provide the reference for clinical work. Methods:From April 2012 to December 2014, 54 patients with posterior malleolus fractures which involve more than 25% ankle joint were treated and followed up. There were 28 patients were treated with the the buttress plate,including 14 males and 15 females and their average age is 40.25 years(range from 18 to 69 years). According to Lauge-Hansen classification system, 9 cases and 13 cases were rated as supination-external rotation type III and type IV respectively,and 7 cases as pronation-external rotation type IV. Twenty-three patients were treated with the the screws,including 14 males and 11 females and their average age is 40.44 years(range from 19 to 66 years). There are 9 cases and 11 cases were rated as supination-external rotation type III and type IV respectively,and 5 cases as pronation-external rotation type IV,according to Lauge-Hansen classification system. Regular follow-up and assess their ankle function with the ankle hindfoot clinical rating system of the American Orthopaedic Foot and Ankle Society(AOFAS). Record and compare their AOFAS score、the time of their fractures heal and the time of their ankle weight-bearing entirely.Results:There are 1 patients( the plate group) lost their follow up,and the 51 patients remained were followed up from 10 to 16 months,with an average period of 13.6 months.There were significant differences in the therapeutic effect between two groups(P>0.05).While there was no obvious meaning in the time of their fractures heal and the time of their ankle weight-bearing entirely between two groups(P<0.05). Conclusion:The plate and the screws can be good method for the treatment of posterior malleolar fracture which involve more than 25% ankle joint.But compared with the screws,the buttress plate could be better because the ankle function can get the maximum recovery early.