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| Effect of Modified Posterolateral Approach to Ankle Joint Combined with Medial Approach on Trimalleolus Fracture |
| ZENG Huaqun, WU Zhihai, XU Yiying, SU Zhugen |
| Jinnan Branch of Jinjiang Municipal Hospital, Fujian Province, Jinjiang 362241, China |
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Abstract Objective: To investigate the effect of modified posterolateral approach (PLA) to ankle joint combined with medial approach in the treatment of trimalleolus fracture. Method: The clinical data of 71 patients with trimalleolar fracture admitted to Jinnan Branch of Jinjiang Municipal Hospital from January 2019 to June 2021 were retrospectively analyzed, all patients received internal fixation reduction treatment, including 36 patients received traditional PLA to ankle joint combined with medial approach was traditional group and 35 patients received modified PLA to ankle joint combined with medial approach as the improved group. The efficacy, surgical and fracture healing, visual analog scale (VAS) scores, ankle function and postoperative complications were compared between the two groups. Result: There was no significant difference in efficacy between the two groups (P>0.05). The operation time and hospital stay of the improved group were shorter than those of the traditional group, and the intraoperative blood loss was less than that of the traditional group (P<0.05). There was no significant difference in fracture healing time between the two groups (P>0.05). VAS scores of the improved group were lower than those of the traditional group at 1, 2 and 3 d after surgery (P<0.05). At 3, 6 months and 1 year after surgery, ankle plantar flexion and dorsalflexion motion in the improved group were higher than those of the traditional group, and Baird-Jackson scores were higher than those of the traditional group (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: Both modified PLA to ankle joint and traditional PLA to ankle joint combined with medial approach in the treatment of trimalleolus fracture during internal fixation reduction can achieve good curative effect, which is conducive to postoperative fracture healing, however, the advantages of the improved approach are that it can reduce intraoperative bleeding and operation time, accelerate postoperative discharge of patients, and alleviate early postoperative pain, but has no significant positive effect on reducing postoperative complications.
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Received: 17 January 2023
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