Xia Demeng, Zhang Yuntong, Ou Tianle, Wang Yang, Hao Zichen, Zhou Panyu, Xu Shuogui
Department of Emergency, Changhai Hospital, Naval Medical University, Shanghai, China.
Department of Orthopaedics, The Naval Hospital of Eastern Theater Command of PLA, Zhoushan, China.
Ann Transl Med. 2020 Dec;8(23):1573. doi: 10.21037/atm-20-4055.
Lateral malleolus fractures occur frequently. The common techniques for fixing purely lateral malleolus fractures are often challenging, owing to the extent of soft tissue damage and fracture non-union. Herein, we report a new treatment that entails minimally invasive insertion and continuous compression of the broken ends as a novel technique, and evaluate its clinical results.
This study enrolled 21 patients (13 males and 8 females; mean age 32.06±3.45 years, range 23-69 years) with purely lateral malleolus fractures. Each patient underwent open reduction treatment with a mini locking plate for internal fixation and compression of the fracture end with an Arched Shape-Memory Connector (ASC). The clinical assessments were made using the American Orthopedic Foot and Ankle Society (AOFAS) scores, which were recorded at the final follow-up visit.
The patients were followed for an average of 14.7±1.2 months (range, 12-18 months). None of the patients showed surgical failure, and all of the purely lateral malleolus fractures healed in an average of 12.6±1.5 weeks (range, 10-16 weeks). The mean AOFAS score was 88.94 (range, 83-90).
The new treatment had beneficial outcomes for purely lateral malleolus fractures. Mini locking plates are minimally invasive for surgical intervention, and combined with continuous concentrated compression with an ASC to accelerate osseous healing, they aid in restoration of function and enable early rehabilitation with a low incidence of postoperative complications.
外踝骨折较为常见。由于软组织损伤程度和骨折不愈合的原因，单纯外踝骨折的常用固定技术往往具有挑战性。在此，我们报告一种新的治疗方法，即通过微创插入并对骨折端进行持续加压作为一种新技术，并评估其临床效果。
本研究纳入21例单纯外踝骨折患者（男性13例，女性8例；平均年龄32.06±3.45岁，范围23 - 69岁）。每位患者均接受切开复位，使用微型锁定钢板进行内固定，并使用拱形形状记忆连接器（ASC）对骨折端进行加压。使用美国矫形足踝协会（AOFAS）评分进行临床评估，在末次随访时记录评分。
患者平均随访14.7±1.2个月（范围12 - 18个月）。所有患者均未出现手术失败，所有单纯外踝骨折平均在12.6±1.5周（范围10 - 16周）愈合。AOFAS评分平均为88.94（范围83 - 90）。
这种新的治疗方法对单纯外踝骨折有良好效果。微型锁定钢板手术创伤小，结合ASC进行持续集中加压以加速骨愈合，有助于功能恢复并能早期康复，术后并发症发生率低。
