Heim D, Heim U, Regazzoni P
Departement für Chirurgie, Universitätsspital Basel, Schweiz.
Unfallchirurgie. 1993 Oct;19(5):307-12. doi: 10.1007/BF02588127.
Malleolar fractures with an unstable ankle joint require additional stabilization. Different implants exist: We present the results of 135/155 patients treated with the so-called positioning screw. In 123 patients the positioning screw showed a spontaneous loosening with functional treatment and was therefore removed with the rest of the implants after eight to twelve months. In twelve cases the screw was broken. In 3/21 patients with the old 3.5 mm cortical screw with a core diameter of 1.9 mm in a correct position and in 9/113 patients with the new 3.5 mm cortical screw with inner core of 2.4 mm in an incorrect position.
Positioning screws require early removal only if they fail to loosen or if a persistent limitation of dorsiflexion is still present after three months.
踝关节不稳定的踝关节骨折需要额外的固定。存在不同的植入物：我们展示了155例患者中135例使用所谓定位螺钉治疗的结果。123例患者的定位螺钉在功能治疗后出现自发松动，因此在八至十二个月后与其他植入物一起取出。12例螺钉断裂。在21例使用旧的3.5毫米皮质螺钉（芯直径1.9毫米）且位置正确的患者中有3例，在113例使用新的3.5毫米皮质螺钉（内芯2.4毫米）且位置不正确的患者中有9例。
仅当定位螺钉未松动或三个月后仍存在背屈持续受限的情况时才需要早期取出。
