后踝骨折内固定方法的选择

Selection of internal fixation for posterior malleolar fractures

后踝骨折在踝关节骨折中占很大比例，踝关节骨折合并后踝骨折时其预后要明显差于双踝骨折。虽然在治疗严重踝关节骨折时切开复位内固定已被大多数学者所接受，但在后踝骨折块内固定方法的选择上还存有争议。本文通过对既往后踝骨折生物力学及临床研究文献的阅读及结果总结来比较钢板和螺钉两种内固定方法的优略，从而为后踝骨折手术内固定方法的选择提供参考。

Posterior malleolar fractures make up a large proportion of ankle fractures. The prognosis of an ankle fracture complicated with posterior malleolar fracture is significantly worse than that of bimal]eolar fracture. Although open reduction and internal fixation is generally accepted in treatment of severe malleolar fractures, management of a specific posterior malleolar fracture is controversial. The authors attempt to make a comparison between screw versus buttress plate fixation in the management of posterior malleolar fractures on the basis of literature review of the biomechanies and clinical research concerning posterior malleolar fractures. We hope this review may provide valuable references for selection of internal fixation for a specific posterior malleolar fracture.