Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang-si, Gyeonggi-do, Republic of Korea.
Medicine (Baltimore). 2023 Jan 20;102(3):e32725. doi: 10.1097/MD.0000000000032725.
Ankle fractures involving the posterior malleolus are a relatively common injuries, but various surgical approaches are still being introduced, and the selection of an appropriate surgical method is still controversial. The aim of this study was to introduce the surgical method using a single lateral approach for open reduction and internal fixation for posterior malleolar (PM) fractures associated with Weber B type ankle fractures. In this retrospective study, the single lateral approach was used for osteosynthesis of the PM fracture with Weber B lateral malleolar fractures. A total of 40 patients were followed up at for least 12 months (mean, 23.3; range, 12-88). Clinical assessment was based on the Olerud and Molander score, Foot and Ankle Outcome Score, visual analog scale, and subjective patient satisfaction 1 year after surgery. The accuracy of reduction was evaluated as <1 mm of displacement on the lateral view of the postoperative radiographs. The mean Olerud and Molander ankle score was 85.6 ± 12.7 and the mean Foot and Ankle Outcome Score was 82.7 ± 15.9 at 1-year postoperatively. Acceptable reduction was achieved in 38 of 40 (95%) cases. During the follow-up period, arthritic change was observed in 1 case and limited range of motion was confirmed in 2 cases. There was 1 case of postoperative wound problem and no case of sural nerve injury. The single lateral approach is a relatively simple and convenient method that enables accurate reduction and minimizing complication for fixation of the PM fractures with Weber B lateral malleolar fractures.
涉及后踝的踝关节骨折是一种相对常见的损伤，但各种手术方法仍在不断引入，而合适的手术方法的选择仍存在争议。本研究旨在介绍一种使用单一外侧入路切开复位内固定治疗 Weber B 型踝关节骨折伴后踝骨折的手术方法。在这项回顾性研究中，我们对伴有 Weber B 型外踝骨折的后踝骨折采用单一外侧入路进行骨合成。共有 40 例患者至少随访 12 个月（平均 23.3 岁；范围 12-88 岁）。临床评估基于 Olerud 和 Molander 评分、足踝结局评分、视觉模拟评分和术后 1 年患者的主观满意度。术后侧位 X 线片上的复位准确性评估为<1 mm 的移位。术后 1 年的平均 Olerud 和 Molander 踝关节评分和平均足踝结局评分分别为 85.6 ± 12.7 和 82.7 ± 15.9。40 例患者中有 38 例（95%）达到可接受的复位。在随访期间，1 例出现关节炎改变，2 例证实活动范围有限。术后有 1 例伤口问题，无腓肠神经损伤病例。单一外侧入路是一种相对简单方便的方法，可实现准确复位，最大限度地减少 Weber B 型踝关节骨折伴后踝骨折固定的并发症。
