Posterolateral approach for Maisonneuve injury associated with posterior malleolus fracture / 中华创伤骨科杂志

ABSTRACT

Objective To investigate the surgical treatment of Maisonneuve injury associated with posterior malleolus fracture under direct visualization via the posterolateral approach.Methods Between January 2008 and June 2015,27 patients with Maisonneuve injury associated with posterior malleolus fracture were treated at our department.They were 18 men and 9 women,aged from 20 to 60 years (average,40.1 years).All fractures and syndesmoses received open reduction under direct visualization and internal fixation via the posterolateral approach.The posterior malleolus fractures were fixed with screws or plate and the syndesmoses fixed using cortical bone screws.Functional results were evaluated using the Baird-Jackson ankle scoring system.Results The patients were followed up for 8 to 30 months (average,18 months).No wound infection,necrosis,dehiscence,lose of reduction or implant failure was found during follow-up visits.All cases got bony union at the last visit.The excellent and good rate was 92.6％.Conclusion Since the posterolateral approach allows good access to the Maisonneuve injury and posterior malleolus fracture under direct visualization,it facilitates accurate direct fracture reduction,stable fixation and early exercise.