The Clinical Study Of The Influencing To The Prognosis In Three Operative Opportunity To The Malleolar Fracture

Objective: To observe and revaluate the influence of the closed malleolar fracture in three different operative opportunity-emergency open reduction and internal fixation (with in 24 hours), two kinds of deferred open reduction and internal fixation (2～5days and 6～14 days).Methods: The part of literature study systematically expatiate the relative anatomy of ankle-joint, incidence, risk, pathogenesis, diagnose, grouping of malleolar fractures, vitodynamics and the treatment. This part also systematically retrospected operative opportunity to the closed malleolar fracture at home or abroad. In the part of clinical study, malleolar fractures were from 2006 to 2008, 45 patients of malleolar fractures divided into 3 groups. Treatment group include 15 patients were treated by emergency open reduction and internal fixation. While the two control groups-deferred 2～5 days and deferred 6～14 days open reduction and internal fixation- each include 15 patients were treated by deferred open reduction and internal fixation. Then we statistic and analysis the data to observe and revaluate the influence of the closed malleolar fracture in three different operative opportunityResults: The study and statistics showed: There were no statistical significance in the average time of easement of pain, drying of wound effusion, wound healing. There was statistical significance in the average time of relief of tumor between 6～14 days deferred group and each other group. There were no statistical significance in the average time of relieve of tumor between emergency group and 2～5 days. There was no statistical significance in the grade of the joint function between every two groups at 2nd, 3rd and 4th month.Conclusion: Through the study and statistics we can conclude that the emergency open reduction group was not superior to the deferred open reduction groups on the healing of affected limb soft tissue and the recovery of malleolar articulation function. However considering the lesser suffering, length of stay and burden of expense for emergency operation, we suggest that it’s better to give emergency open reduction and internal fixation to malleolar articulation fracture.