Comparison of clinical outcomes between modified posterolateral approach and traditional posterolateral approach internal fixation in treatment of trimalleolar fracture

HUANG Chao-ming; XIA Shao-xiang; PEI Ru; ZHANG Jie; HE Ren-hao

doi:10.11659/jjssx.05E024146

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Comparison of clinical outcomes between modified posterolateral approach and traditional posterolateral approach internal fixation in treatment of trimalleolar fracture

Clinical Research | 更新时间：2025-05-26

- Comparison of clinical outcomes between modified posterolateral approach and traditional posterolateral approach internal fixation in treatment of trimalleolar fracture
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 5, Pages: 413-416(2025)
- 作者机构：
  
  江苏省人民医院宿迁医院骨科，江苏宿迁223800
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.05E024146
  CLC： R683.42
- Received：29 May 2024，
  
  Published：25 May 2025
- 稿件说明：
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黄朝明,夏绍祥,裴儒等.改良后外侧入路与传统后外侧入路内固定治疗三踝骨折的疗效对比[J].局解手术学杂志,2025,34(05):413-416.

HUANG Chao-ming,XIA Shao-xiang,PEI Ru,et al.Comparison of clinical outcomes between modified posterolateral approach and traditional posterolateral approach internal fixation in treatment of trimalleolar fracture[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(05):413-416.
黄朝明,夏绍祥,裴儒等.改良后外侧入路与传统后外侧入路内固定治疗三踝骨折的疗效对比[J].局解手术学杂志,2025,34(05):413-416. DOI： 10.11659/jjssx.05E024146.

HUANG Chao-ming,XIA Shao-xiang,PEI Ru,et al.Comparison of clinical outcomes between modified posterolateral approach and traditional posterolateral approach internal fixation in treatment of trimalleolar fracture[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(05):413-416. DOI： 10.11659/jjssx.05E024146.

摘要

目的

比较改良后外侧入路与传统后外侧入路联合内侧入路切开复位内固定治疗三踝骨折的早期临床疗效。

方法

选择我院骨科2019年1月至2022年6月收治的62例经改良后外侧入路联合内侧入路行切开复位钢板内固定治疗的三踝骨折患者作为改良入路组，匹配同期行传统后外侧入路联合内侧入路的62例患者作为传统入路组。收集患者围术期指标，测量术后12个月踝关节活动度，采用Maryland评分、美国足踝外科协会(AOFAS)评分及Baird-Jackson评分评价术后12个月患者恢复情况并记录并发症发生情况。

结果

2组患者手术时间、术中失血量、切口长度、术后引流量及疼痛评分比较，差异无统计学意义（

0.05）。2组患者术后12个月的Maryland评分、AOFAS评分及Baird-Jackson评分均高于术前（

0.05），但组间比较差异均无统计学意义（

0.05）。改良入路组患者术后12个月踝关节活动度优于传统入路组，术后神经损伤发生率低于传统入路组，差异均有统计学意义（

0.05）。

结论

改良后外侧入路联合内侧入路切开复位内固定治疗三踝骨折能取得良好早期疗效，可有效改善踝关节活动度，并减少术后神经损伤。

Abstract

Objective

To compare the clinical outcomes of modified posterolateral approach and traditional posterolateral approach combined with open reduction and internal fixation via medial approach in treatment of trimalleolar fracture.

Methods

Sixty-two patients with trimalleolar fractures who underwent modified posterolateral approach combined with open reduction and internal fixation via medial approach from January 2019 to June 2022 in orthopedics department of our hospital were enrolled in the modified approach group，and 62 patients who underwent traditional posterolateral approach combined with open reduction and internal fixation via medial approach at the same period were matched as the traditional approach group. The perioperative indicators were collected. The range of ankle motion 12 months after surgery was measured. The Maryland score，American Orthopaedic Foot and Ankle Society （AOFAS） score and Baird-Jackson score were employed to evaluate the recovery of patients 12 months after surgery，and the occurence of complications was recorded.

Results

There was no significant difference in the operation time，intraoperative blood loss，incision length，postoperative drainage volume or pain score between the two groups （

0.05）. The Maryland scores，AOFAS scores and Baird-Jackson scores 12 months after surgery of the two groups were higher than those before operation （

0.05），while there was no significant difference between the two groups （

0.05）. The range of ankle motion in the modified approach group was better than that in the traditional approach group，and the incidence of nerve injury after surgery was lower than that in the traditional approach group，with statistically significant differences （

0.05）.

Conclusions

The modified posterolateral approach combined with open reduction and internal fixation via medial approach in treatment of trimalleolar fracture can achieve good early clinical outcome，effectively improve range of ankle motion，and reduce postoperative nerve injury.

关键词

Keywords

references

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