Comparison of the efficacy of different fixation techniques in the treatment of Haraguchi type II posterior malleolar fractures associated with supination-external rotation

Abstract

Abstract Purpose To compare the efficacy of different surgical fixation techniques in the treatment of Haraguchi type II posterior malleolar fractures associated with supination-external rotation. Methods A total of 163 patients with Haraguchi type II posterior malleolar fractures ( 44-B) were retrospectively enrolled in the study, of which 96 and 67 were treated with plates and screws, respectively. For these patients, imaging and clinical findings, functional status, visual analog scale(VAS) for pain, incidence of deep and superficial surgical site infections, intraoperative blood loss, and surgical duration were evaluated and compared. Results No significant differences were identified in American Orthopaedic Foot and Ankle Surgery (AOFAS) scores or deep surgical site infections between the patients treated with plates and those treated with screws. Compared with the screw group, the plate group had more bleeding, a longer surgical duration, and a higher incidence of superficial infections (all cured by changing dressings). However, The plate group had an earlier time to full weight-bearing and a lower incidence of venous thrombosis of the lower extremity. Conclusion Both internal fixation techniques demonstrated good clinical outcomes. The plate group tolerated early weight-bearing training and had a lower incidence of venous thrombosis complications, compared with the screw group. The screw group underwent a less invasive operation and had a lower incidence of infection, making it a good choice for patients with unfavorable skin conditions.