The Comparison Of Two Kinds Of Operation Sequence Of Internal Fixation Of Ankle Fractures

Objective: In order to improve the excellent rate of surgical treatment of three ankle fractures,the curative effects of two different surgical reduction and fixation sequence(i.e.lateral malleolus-posterior malleolus-medial malleolus and posterior malleolus-lateral malleolus-medial malleolus)were compared and analyzed.It is hoped that the experimental data can be more reasonable in choosing the reduction and fixation sequence during the sugical treatment of this kind of fractures.Methods: In this study,30 patients with trimalleolar fractures were selected according to the AO classification criteria for the classification of ankle fractures,which were from the ankle fracture patients who were admitted to the depatment of orthopedics.There were 13 female patients and 17 male patients,divided into two groups,15 patients in each group,and two diffent sequence of reduction and fixation were used randomly.Group I was treated with the sequence of posterior malleolus first,lateral malleolus second,medial malleolus last.Group II was treated with the sequence of lateral malleolus first,posterior malleolus second,medial malleolus last.The time of operation,the total amount of bleeding and the number of adjustments of posterior malleolus were observed during operation.The time of hospital stay and the standard of clinical healing were recorded after the operation.All the 30 patients were followed up 6 months after the operation and the ankle function was scored according to the ankle foot scale.The scoring is based on the ankle foot scale,which is established by the American foot and ankle surgery association.Results: There were statistically significant differences in the average operative time,the number of adjustment of the posterior malleolus and the amount of intraoperative bleeding in the two reduction sequences(P < 0.05).There were no statistically significant differences in hospital stay,clinical healing time,and ankle foot function scores(P >0.05).Conclusion: Posterior malleolus first,lateral malleolus second,medial malleolulast last in three ankles' fracture's operation can reduce the operation time,the number of adjustment of posterior malleolus and the amount of bleeding in the operation,but there is no obvious advantage in the time of hospitalization,the healing time and ankle function score.