Operation position selection according to types of trimalleolus fractures

Abstract

Objective To evaluate the curative efficacy of appropriate operation positions selected according to different fracture types of trimalleolus fractures.Methods Twenty-nine patients of trimalleolus fractures were performed open reduction and internal fixation from January 2007 to January 2010 ( the study group).There were 21 males and 8 females at average age of 41 years (range,20-67 years).According to Lauge-Hansen typing,there were nine patients with pronation-external rotation type,one with pronation-abduction type,17 with supination-external rotation type and two with supination- adduction type.Operation positions were selected according to fracture types and CT:prone position was selected in 10 patients,lateral to supine position in 15 and supine position in four.In the control group,there were 29 patients including nine patients with pronation-external rotation type,17 with supination-external rotation type,two with supination- adduction type and one with pronation-abduction type.All the patients were in supine to prone position.The operation time,blood loss,wound healing time and fracture healing time were compared in the two groups.Results All the patients in the study group were followed up for mean duration of 21 months (range,5-36 months).Satisfactory fracture reduction was obtained:the fractures reached anatomy reduction in radiological manifestation; weight beating surface of the ankle was perpendicular to the longitudinal axis of lower leg; the surface of the ankle was smooth.The operation time was 102.5 minutes in the study group and 156.8 min in the control group.The mean operation time,mean blood loss and mean wound healing time were 102.5 min,145.6 ml,14.6 days respectively in the study group,and were 156.8 min,270.3 ml and 19.3 days in the control group,with significant difference (P＜0.05).The fracture healing time was 14.2 weeks in the study group and 15.4 weeks in the control group,with no statistical difference (P ＞ O.05 ).Conclusion Selection of appropriate operation positions according to different fracture types of trimalleolus fractures is contributive to shorter operation time,less blood loss and shorter fracture healing time. Key words: Ankle joint; Fractures; Ankle injuries