Dr AKM Nazmul Haque, Junior Consultant (Orthopedics), Department of Orthopedics, Mymensingh Medical College Hospital, Mymensingh, Bangladesh; E-mail:
Mymensingh Med J. 2021 Jul;30(3):644-650.
Danis-Weber type-B ankle fracture is one of the most common injuries in young and active individual. This fracture offers a considerable challenge to orthopedic surgeon. Though there are several options for treating such type of fracture, ORIF by Pre-contoured Distal Fibular Locking Plate is the preferred option in the recent years. This descriptive type of observational study was performed from July 2017 to June 2019 in NITOR. Thirty (30) patients, 22 male and 8 female with an average age of 39 years with Danis-Weber type-B ankle fracture underwent ORIF by Pre-contoured Distal Fibular Locking Plate for fractured fibula and ORIF by 4.0mm cannulated cancellous screw for fractured medial malleolus. All the patients were initially managed by analgesic and short leg posterior slab. Average follow up was 24 weeks. Final outcome was assessed by AOFAS score. The main cause of injury was RTA (56.67%). Mean operation time was 1.2 hours. Mean duration of Hospital stay was 16.43±1.73 days. Superficial infection was in 3.33% and skin necrosis in 3.33% patient. Mean duration of radiological healing was 12.73±0.39 weeks. At final follow up, mean dorsi flexion was 10.93°±0.357° and plantar flexion was 50.93°±0.357°. Ninety percent (90%) patient had no difficulties in walking on any surface; 96.67% patient had stable ankle hind foot; 86.67% patient had good. Ten percent (10%) had fair and 3.33% patient had poor alignment of foot. The mean score in this study was 88.67±2.31. Satisfactory outcome was observed in 86.67% patients and 13.33% had unsatisfactory results. On the basis of results in the present study, it can be concluded that treatment of Danis-Weber type-B ankle fracture by Pre-contoured Distal Fibular Locking Plate is an effective and reliable method.
Danis-Weber 型 B 型踝关节骨折是年轻和活跃人群中最常见的损伤之一。这种骨折对骨科医生来说是一个相当大的挑战。尽管有几种治疗这种类型骨折的方法，但近年来，预成型远端腓骨锁定钢板内固定（ORIF）是首选方法。本研究为 2017 年 7 月至 2019 年 6 月在 NITOR 进行的一项描述性观察研究。30 例（30 例）患者，男 22 例，女 8 例，平均年龄 39 岁，均为 Danis-Weber 型 B 型踝关节骨折，其中腓骨骨折采用预成型远端腓骨锁定钢板 ORIF，内踝骨折采用 4.0mm 空心松质骨螺钉 ORIF。所有患者均采用镇痛和短腿后板进行初步治疗。平均随访 24 周。最终结果采用美国足踝外科协会（AOFAS）评分进行评估。主要损伤原因是 RTA（56.67%）。平均手术时间为 1.2 小时。平均住院时间为 16.43±1.73 天。感染发生率为 3.33%，皮肤坏死发生率为 3.33%。平均影像学愈合时间为 12.73±0.39 周。最终随访时，背屈平均为 10.93°±0.357°，跖屈平均为 50.93°±0.357°。90%（90%）的患者在任何表面行走均无困难；96.67%的患者踝关节距下关节稳定；86.67%的患者效果良好。10%（10%）为可接受，3.33%为差。本研究平均得分为 88.67±2.31。86.67%的患者疗效满意，13.33%的患者疗效不满意。根据本研究结果，可以得出结论，预成型远端腓骨锁定钢板治疗 Danis-Weber 型 B 型踝关节骨折是一种有效可靠的方法。
