Abstract
Objective To discuss clinical results and techniques of treatment of posterior malleolar fractures by fixation with minimally invasive percutaneous cannulated screws. Methods A total of 18posterior malleolar fractures were treated with percutaneous cannulated screws (4.0 ram) between March 2004 and September 2006. According to Lauge-Hansen system, 14 were diagnosed as supination external rotation stage Ⅳ, and 4 as pronation external rotation stage Ⅳ. In all cases, the size of fragment exceeded 25% of the articular surface with displacement of more than 2 mm on the lateral radiograph. We studied the preoperative CT to determine the size of the posterior fragment, displacement and the angle between the bimalleolar axis and the major fracture line of the posterior malleolus. After ORIF of outer and medial malleoli, the posterior malleolus was treated by minimally invasive osteosynthesis. Results Follow-ups of 16.5 (range, 6-35) months on average revealed that all cases healed. According to the Ankle Hindfoot Clinical Rating System of the American Orthopaedic Foot & Ankle Society (AOFAS), the results were rated as excellent in 11 cases, good in 5 cases,moderate in 1 case, and poor in 1 case, with the good-excellent rate being 88.9%. Conclusions Fixation with minimally invasive percutaneous cannulated screws is a good method with advantages of mini-invasion and rigid fixation. Careful preoperative plan according to CT scan is a prerequisite for good results. Key words: Posterior malleolar; Fracture; Fracture fixation,internal
Published Version
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