两种方法治疗后踝骨折的三踝骨折病例的疗效分析

目的探讨经皮前方螺钉内固定及后外侧入路内固定后踝骨折治疗三踝骨折的方法及疗效对比。方法2012年1月至2016年12月共收治三踝骨折患者43例，男23例，女20例，年龄18—62岁，平均年龄36岁。所有患者根据骨折类型分为A（经皮前方螺钉内固定）、B组（后外侧入路暴露后踝骨折并内固定），术后随访评估患者骨折愈合情况及踝关节功能情观。结果两组患者骨折均得到愈合，骨折复住情况B组优于A组，短期随访踝关节功能无明显差异。结论经皮前方螺钉内固定及后外侧入路内固定后踝骨折均是治疗三踝骨折的有效方法，术者可根据个人经验、骨折类型选择合适的手术方式。

Objective To compare clinical techniques and results of two methods for treatment of posterior malleolar fractures by fixation with minimally invasive percutaneous cannulated screws and internal fixation through posterior lateral approach in three ankle fractures cases. Methods A total of 43 posterior malleolar fractures cases including 23 males, 20 females, aging from 18~62 years old （ average 36 ） were treated with the two methods from January 2012 to December 2016.All the cases were divided into two groups according to types of fractures： group A treated with minimally invasive percutaneous cannulated screws, group B treated with internal fixation through posterior lateral approach.The status of union of the fractures and functional results of the ankle were estimated post-operationally. ResuRs All the fractures of the two group got union by the last followup, group B showed a better status of reduction than group A, the short time functional results showed no significant difference.Conclusions Fixation with minimally invasive percutaneous cannulated screws and internal fixation through posterior lateral approach are both good methods for treatment of three ankle fractures.Operators can choose a proper methods by personal favors and types of fractures.