Abstract:

BACKGROUND: Previously, the roentgenoscopy, medial malleolus dislocation and lateral malleolus osteotomy often used in reduction and fixation of posterior malleolar fractures are dissatisfied to different extents. Direct vision method can provide an alternative way to observe the posterior malleolus.
OBJECTIVE: To compare the direct vision and roentgenoscopy during screw fixation of the posterior malleolar fractures.
METHODS: Twenty-six patients with posterior malleolar fractures were selected from Beijing Jishuitan Hospital between January 2006 and December 2006. The patients were divided into two groups according to sex, age, fracture type, time from injury to operation, and 13 cases were in each group. Roentgenoscopy group received the roentgenoscopy to observe the reduction and fixation of the posterior malleolar fragments, and direct vision group underwent direct vision.
RESULTS AND CONCLUSION: The average time of follow-up was 23 (17-29) months in the direct vision group and 22.5 (17-28) months in the roentgenoscopy group. All the 26 cases had bone union wth the anatomic reduction of the posterior malleolar fragments. The time for reduction and fixation of posterior malleolar fractures was (8.08±1.55) minutes in the direct vision group and (20.15±4.22) minutes in the roentgenoscopy group (P < 0.01). There was a significant difference in the number of x-ray fluoroscopy between the direct vision group (3-8 times) and roentgenoscopy group (once) (P < 0.01). The AOFAS scores were 86-100, 96 on average, in both two groups, including 11 excellent cases and 2 good cases. It is indicated that the direct vision method is superior to the roentgenoscopy.