Modified Posterolateral Approach for the Treatment of 2-Part Fractures of the Posterior Malleolus Associated with Medial and Lateral Malleolar Fractures: 1 Incision, 2 Windows, 3 Steel Plates.

BACKGROUND The aim of this study was to investigate the effect of the modified posterolateral approach using 1 incision, 2 windows, and 3 plates in the treatment of 2-part posterior malleolus fractures complicated with medial and lateral malleolus fractures. MATERIAL AND METHODS Twelve patients with 2-part fractures of the posterior malleolus complicated with medial and lateral malleolar fractures and treated by the modified posterolateral approach from January 2018 to January 2021 were studied retrospectively. After surgery, the ankle hindfoot score and visual analog scale (VAS) of the American Orthopedic Foot and Ankle Society (AOFAS) were used for evaluation. RESULTS The average follow-up time of the 12 patients was 18 months (7-30 months). All patients had no infection, and their incisions healed in the first stage. Postoperative radiography showed that the average fracture healing time was 12.5 weeks (10-15 weeks). The average time for patients to walk weight bearing was 13 weeks (11-16 weeks), and there was no obvious pain or discomfort. At the last follow-up, the average AOFAS ankle hindfoot score of the 12 patients was 87.5 (77-95), with 7 excellent and 5 good scores. The VAS score improved from before surgery (average 8.25 points) to after surgery (average 1 point). The curative effect was satisfactory. CONCLUSIONS The posterolateral approach using 1 incision, 2 windows, and 3 steel plates was effective in the treatment of 2-part posterior malleolus fractures complicated with medial and lateral malleolus fractures.