In patients with posterior malleolus fractures, secondary displacement of the posterior malleolus fracture may occur during the insertion of intramedullary nailing. However, posterior malleolus fractures are joint-site fractures, and single intramedullary nailing is not appropriate for fractures involving the periarticular and metaphyseal regions. The patients have good tolerance, early bearing time, low reoperation rate and poor line of force. Intramedullary nailing is the first choice for tibial fracture fixation. As mentioned above, as clinicians realize the strong correlation between tibial spiral fracture and posterior malleolus fracture and the popularization of CT and other examination technologies, more and more posterior malleolus fractures related to tibial spiral fracture are detected, and at the same time, its treatment problems are gradually paid attention to. examined 288 patients with tibial spiral fractures and found that 16.7% had posterior malleolus fractures. Bostman first reported that 0.6% of tibial shaft fractures were complicated by ankle fractures Van der Werken and Zeegers reported an incidence of 11.5%. Tibial spiral fracture combined with posterior malleolar fracture is a regular combination, and posterior malleolar fracture(PMF)is usually hidden. This fixation technology is also characterized by simple and fast operation. Conclusionįor the injury of tibial spiral fracture combined with PMF, our fixation technology can achieve minimally invasive fixation of PMF with percutaneous screws on the basis of intramedullary nail fixation of tibial fracture, promoting early functional exercise of ankle joint and early weight bearing of patients. The blood loss of FG was 66.8☑2.3 ml, the blood loss of NG was 65.6☑1.7 ml, the VAS score of FG was 1.37☐.47, the VAS score of NG was 1.43☐.51, the dorsiflexion restriction of FG was 5.8±4.1 the NG was 6.1±5.7. There were no significant difference in blood loss, VAS and dorsiflexion restriction of ankle joint between the two groups. The operation time of FG was 67.9☑1.2 min, and that of NG was 60.8☙.4 min The weight bearing time of FG was 57.35☓4.72 days, and that of NG was 69.17☒1.43 days The AOFAS score of FG was 92.50☓.46, and that of NG was 91.00±4.16. There were statistical differences between the two groups in terms of operation time, AOFAS score and weight bearing time. The fracture of both groups healed.2 patients in NG had secondary displacement of PMF during operation, and the fracture finally healed after fixation. Collected the operation and postoperative recovery of the two groups of patients, including the operation time, intraoperative blood loss, AOFAS score, VAS score and dorsiflexion restriction of ankle joint at the last follow-up, and compared whether there is any difference between the two groups of patients. ![]() After minimally invasive percutaneous screw fixation of ankle fracture in FG patients, the tibial intramedullary nail was inserted to fix the fracture. Materials and methodsįrom January 2017 to February 2020, 116 cases of spiral fracture of tibia combined with PMF who were operated in our hospital were divided into Fixation Group (FG) and No Fixation Group (NG) according to whether PMF was fixed. This study aims to explore the effectiveness and advantages of this technology. We proposed a minimally invasive percutaneous screw combined with intramedullary nail technology to fix the PMF in the tibial spiral fracture. Intramedullary nail is the first choice for the treatment of tibial spiral fracture. There is no uniform fixation method for PMF in this kind of injury. Spiral fracture of tibia combined with posterior malleolar fracture (PMF) is a special and regular injury.
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