9 / 2017-04-27 23:07:00

Transfibular Approach combine with Modified Posterolateral Curved Incision to Posterior Malleolus Fracture Fixation

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Objective: Complex high-energy posterior malleolus fracture (PM) is usually accompanied with bone fragment impacted in fracture gap, which can cause poor reduction and and ankle pain. To remove the bone fragments and reduct the PM, transfibular approach combine with modified posterolateral curved incision has been applied to PM, which is in the same plane as the distal fibula fractures line.
Methods: Between Jujy 2016 to April 2017, 36 patients (11 males and 25 females) of the PM which is in the same plane as the distal fibula fractures line that is common to supination-eversion fractures of ankle. All patients in a supine position and under tourniquet control, a modified posterolateral curved incision was used to widen the operation field of vision exposing the fibula, especially distal tibiofibular syndesmosis. It’s not only helping surgeon to operate, remove the bone fragments which were stuck in anterior tibiofibular ligament (ATL) and evaluate the biomechanical stability of ATL in ankle fracture. Through the fracture gap of fibula, the bone fragments can been easily obtained. Fracture of medial malleolus general use cannulated screw internal fixation.
Results: The operation time was 105～170(116.18±10.22) min. Introperative blood loss was 10～100(37.86±16.04)ml. All patients have good reduction and effective internal fixation.
Conclusions: Transfibular approach combine with modified posterolateral curved incision is a good method to remove the bone fragments and reduct the PM.