Clinical Observation of Intergrated Traditional Chinese and Western Medicine in Treating Posterior Malleolas Fracture
JIA Zhong-bao,CUI Na,LANG Lin
Orthopedics Depaitment of NanYuan Hospital, Beijing 100076, China.
Abstract:
Objective To investigate the clinical effect of integrated traditional Chinese and Western medicine for treating involved posterior malleolus fracture. Methods The clinical data of 40 patients with involved posterior malleolar fracture undergoing hollow screw internal fixation by open reduction or closed reduction and TCM therapy in Nanyuan Hospital from February 2012 to October 2015 were retrospectively analyzed, including 23 cases of lateral approach with open reduction and 17 cases of closed reduction and TCM therapy. The operation time, fracture healing time, postoperative non-weight-bearing time and complications were recorded and compared between the two groups. The ankle joint function at postoperative 12 months in the two groups was evaluated by Olerud-Molander. Results The operating time and facture healing time in the closed reduction group were obviously shorter than those in the lateral approach with open reduction group, the differences were statistically significant (P<0.05). The patients in the two groups gradually began to conduct loaded exercise at about postoperative 6 weeks. The postoperative non-weight-bearing time had no statistical difference between the two groups (P>0.05). The two groups obtained the bony healing during 5–7 months follow up. The lateral approach with open reduction group had 3 cases of super.cial infection. The closed reduction group had 1 case of articular surface collapse and 1 case of pain. The ankle joint function score in the lateral approach with open reduction group was (83.51±8.44) points, in which 16 cases were excellent, 4 cases were good, 3 cases were fair and 0 case was poor; the ankle joint function score in the closed reduction group was (80.83±9.61) points，in which 12 cases were excellent, 3 cases were good, 1 case was fair and 1 case was poor, the articular function score had no statistical difference between the two groups (P>0.05). Conclusion The clinical effect of open reduction and internal fixation with posterolateral approach is similar to that of closed reduction and TCM therapy and internal .xation in the treatment of ankle fracture. The operation time of open reduction and internal fixation is long, local soft tissue injury is heavy, closed reduction and internal fixation requires high technology, and the operation time is short. For a single posterior malleolus fracture, a losed reduction is recommended, and for fractures with medial and lateral malleolus, open reduction via a posterolateral approach is recommended.
