Ostrum R F
Division of Orthopaedic Surgery, Ohio State University, Columbus 43215, USA.
J Orthop Trauma. 1996;10(3):199-203. doi: 10.1097/00005131-199604000-00008.
This is a prospective study that examines 32 patients who were treated with posterior plating of a displaced Weber B fibula fracture and had a minimum of 1 year follow-up. The surgical technique included application of an unbent one-third tubular plate to the posterior aspect of the fibula using the antiglide technique. Twenty-seven fractures were classified as supination-eversion IV: 13 with deltoid disruption and 14 with a medial malleolar fracture. Three were classified as pronation-abduction and two as low pronation-eversion fractures at the level of the plafond. A six-hole plate was used most often (18 cases), and 23 patients had a lag screw placed through the plate. There were no nonunions or malunions. No wound complications, screw loosening, loss of fixation, intraarticular screws, or palpable screws were found. Four patients had transient peroneal tendinitis that resolved in 4-8 weeks. Two patients had later plate removal caused by poor technique because of a symptomatic lag screw. Twenty of the 21 patients who returned a questionnaire were satisfied with their result (95%). Posterior fibular plating offers many advantages over lateral plating, including the possibility of no intraarticular or palpable screws and an improved and stronger distal fixation construct. Our favorable results suggest that this technique should be given consideration as a treatment of choice for displaced Weber B fibula fractures.
这是一项前瞻性研究，研究对象为32例接受移位型Weber B型腓骨骨折后路钢板固定治疗且随访至少1年的患者。手术技术包括采用防滑技术将未弯曲的三分之一管状钢板应用于腓骨后侧。27例骨折分类为旋后-外翻IV型：13例伴有三角韧带断裂，14例伴有内踝骨折。3例为旋前-外展型，2例为距骨平台水平的低位旋前-外翻骨折。最常使用六孔钢板（18例），23例患者通过钢板置入拉力螺钉。无骨不连或骨畸形愈合。未发现伤口并发症、螺钉松动、内固定失效、关节内螺钉或可触及的螺钉。4例患者出现短暂性腓骨肌腱炎，4-8周内缓解。2例患者因拉力螺钉出现症状，技术欠佳，后期取出钢板。21例回复问卷的患者中有20例对结果满意（95%）。腓骨后侧钢板固定相对于外侧钢板固定具有许多优点，包括无关节内或可触及螺钉的可能性，以及改进且更坚固的远端固定结构。我们的良好结果表明，该技术应被视为移位型Weber B型腓骨骨折的一种治疗选择。
