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| Clinical results of external fixator pinning in anterior process of calcaneus combined with open reduction and internal fixation for treatment of instable ankle fracture |
| LIU Chang ZHANG Haisen PEI Baojing SU Ke WANG Qinghai BAI Yuming LI Longjie |
| Sencod Derpatment of Orthopaedics Surgery, Central Hospital of Cangzhou City, Hebei Province, Cangzhou 061001, China |
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Abstract Objective To investigate clinical effect of the external fixator pinning in anterior process of calcaneus combined with open reduction and internal fixation in treatment of instable trimalleolar fracture of the ankle. Methods From January 2012 to December 2015, in Central Hospital of Cangzhou City, the clinical data of 23 patients with instable trimalleolar fracture of the ankle treated by the external fixator pinning in anterior process of calcaneus combined with open reduction and internal fixation were retrospectively analyzed. All cases were closed fractures with posterior subluxation of the talus. All patients had posterior malleolar fragments involving the tibial articular surface ≥25%. According to Lauge-Hansen classification, 9 cases were with pronation external rotation type Ⅳ, 14 cases with supination and external rotation type Ⅳ. External fixator was relaxed for once per week after operation 4 weeks in order to exercise motion of ankle. At postoperative fellow-up, outcomes were measured by clinical scores and serial radiographic analysis. Results The operation time was (59.5±21.4) min, intraoperative blood loss was (101.5±33.7) mL, and length of stay was (11.5±3.3) d. Regarding complications, one cases (4.3%) had postoperative superficial inflammatory reaction around fibular incision, they healed well afer surgery treatment. There was no occurrence of injury fo blood vessels or nerves. The incidence of perioperative complications was 4.3%. All patients were followed up for mean (15.8±4.3) months. All fractures were healed without loss of reduction. For Lowa ankle score and VAS score, there was not significant different during postoperative follow-up points (P > 0.05). At the last follow-up, Lowa ankle score and VAS score were (86.9±5.4), (2.7±0.6) scores. According to the Maryland score, the good rate of the curative effect was 91.3%. Conclusion Clinical results of the external fixator pinning in anterior process of calcaneus combines with open reduction and internal fixation in treatment of instable trimalleolar fracture of the ankleare is good. The complication rate is low. This is an alternative method in the treatment ofinstable trimalleolar fracture of the ankle.
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