Low-profile anatomical buttress plate for treatment of vertical shear medial malleolus fractures / 中华创伤杂志

ABSTRACT

Objective To investigate the efficacy of low-profile anatomical buttress plate in treating vertical shear medial malleolus fractures.Methods A retrospective case series study was conducted on the clinical data of 20 patients with vertical shear medial malleolus fractures admitted from February 2013 to February 2015.A total of 13 males and seven females were included in the study,with an average age of 45.8 years.There were 11 patients with medial combined with lateral malleolus fractures,one with medial malleolus fracture,six with medial combined with posterior and lateral malleolus fractures,and two with medial combined with distal tibial fractures.All patients were treated with low-profile anatomical buttress plate.Bone union,reduction loss,internal fixation stability,and incidence of ostearthritis were recorded.The postoperative ankle function was evaluated according to American Orthopedic Foot and Ankle Society (AOFAS) score.Results All patients were followed up for26.5 months on average (range,18-37 months).Anatomical reduction was seen in all patients according to X ray.Patients were seen bone union after an average of 15.6 weeks.After 8-16 weeks,patients were able to walk and return to work,averaging 12.5 weeks.Patients were able to do physical exercise after 20-26 weeks (mean,22.5 weeks).The follow-up showed no complications such as reduction loss,internal fixation loosening or breakage.Bone nonunion was not seen,and no manifestation of osteoarthritis was shown in the images.An average AOFAS score of 88.6 points (range,75-100 points) was reported at the final follow-up.The scoring outcome was excellent in 13 patients and good in seven,with excellent and good rate of 100％.Conclusions The low-profile anatomical buttress plate for fixation of vertical shear medial malleolus fractures has advantages of firm fixation,early mobilization and sound function recovery.The plate can be a safe and effective method for the treatment of vertical shear medial malleolus fractures.