[Case-control study on treatment of ankle fractures of supination-extorsion with different fixed position]

To explore the best external fixation posture of ankle fracture of Lauge-Hanson III degree and IV degree supintion-eversion after manipulation.

From January 2007 to June 2010, 46 patients with ankle fracture of Lauge-Hanson III degree and IV degree supintion-eversion were selected for this study and were randomly divided into two groups (group A and group B). There were 14 males and 9 females in group A; and the Lauge-Hanson III degree was in 13 cases and IV degree was in 10 cases; fractures were reduced and fixed with plaster splint of U-shape to the posture with inversion, internal rotation and plantar flexion. There was 15 males and 8 females in group B, and the Lauge-Hanson III degree was in 14 case and IV degree was in 9 cases; fractures were reduced and fixed with plaster splint of U-shape to the posture with inversion, internal rotation and dorsiflexion. The clinical effects were evaluated according to AOFAS scoring system.

All the patient were followed up from 6 to 18 months with an average of 12 months. In group A, AOFAS scoring was from 73 to 100 scores with an average of (92.58 +/- 5.73) scores, 16 cases obtained excellent results, 6 good, 1 fair; in group B, AOFAS scoring was from 66 to 100 scores with an average of (85.74 +/- 7.56) scores, 9 cases obtained excellent results, 7 good, 6 fair and 1 poor. The result of group A was better than that of group B. In group A, 1 case occurred with ankle joint ache after long walk and swelling in night. In group B, 6 cases also occurred with ankle joint ache after long walk and swelling in night and 1 case with stiffness of joint. So there was obvious difference (P < 0.05).

For treatment of ankle fracture of Lauge-Hanson III degree and IV degree supintion-eversion, the posture with inversion, internal rotation and plantar flexion exceeds another one with inversion, internal rotation and dorsiflexion with plaster after manipulative reduction.