The role of locking plate in lateral malleolar fracture fixation for the elderly remains unclear. The aim of our study is to compare radiological and functional outcomes in older patients (> 50 years) with AO/OTA 44B lateral malleolar fractures after locking plate (PLP) or one-third non-locking tubular plate (TP) lateral fixation. We retrospectively reviewed the medical records of 72 patients (PLP group, 34 patients; TP group, 38 patients; mean age, 61.9 ± 7.6 years; range, 51–80 years; follow-up, 1 year). Patients with open fractures, syndesmosis injuries, and a previous ankle trauma or surgery were excluded. Demographic data, union rate, complications, radiographic outcomes, visual analog scale (VAS) scores, and foot and ankle outcome scores (FAOSs) between the groups were recorded and compared. We also investigated the association of clinical features with pain and function. Statistically, the Fisher’s exact test was used for categorical variables and the Mann-Whitney U test for the continuous variables. The final model for the multiple regression analysis was used to predict factors related to functional outcomes. There were no significant between-group differences in demographic data, complication rates, immediately postoperative distal fibula lengths, ankle osteoarthritis (OA) grades, talar tilt angles (TTAs) ≥ 2°, or reduction accuracy. All fractures achieved union. The PLP group had significantly lower rates of distal screw loosening, fibula shortening > 2 mm, OA grade progression, and TTAs ≥ 2°, and better FAOSs and VAS scores than was the case for the TP group after 1 year of follow-up (all p < 0.05). The severity of OA, TTA ≥ 2°, and distal screw loosening were positively associated with VAS scores, and negatively associated with FAOSs. When treating AO/OTA 44B fractures in patients over 50 years of age, PLPs provided better VAS scores, FAOSs, and radiological outcomes, including less fibula shortening > 2 mm, less osteoarthritic (OA) ankle progression, less implant removal rate, and fewer TTAs ≥ 2° than was the case for TPs after a 1-year follow-up. Therapeutic level III

中文翻译：

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治疗50岁以上患者的AO / OTA 44B外侧踝骨折：关节周围锁定钢板与非锁定钢板

锁定板在老年人侧踝骨折固定中的作用尚不清楚。我们的研究目的是比较锁定钢板（PLP）或三分之一非锁定管状钢板（TP）侧固定后AO / OTA 44B侧踝骨折的老年患者（> 50岁）的放射学和功能结局。我们回顾性回顾了72例患者的病历（PLP组34例； TP组38例；平均年龄61.9±7.6岁；范围51-80岁；随访1年）。患有开放性骨折，胫骨联合损伤以及先前的踝关节外伤或手术的患者被排除在外。记录并比较两组之间的人口统计学数据，并集率，并发症，放射学结局，视觉模拟量表（VAS）得分以及足踝关节结局得分（FAOSs）。我们还研究了临床特征与疼痛和功能的关系。从统计学上讲，Fisher精确检验用于分类变量，Mann-Whitney U检验用于连续变量。多元回归分析的最终模型用于预测与功能结局相关的因素。两组之间的人口统计学数据，并发症发生率，术后远端腓骨长度，踝骨关节炎（OA）等级，距骨倾斜角（TTA）≥2°或复位精度均无明显差异。所有骨折均愈合。与TP组相比，PLP组在术后1年的随访中远侧螺钉松动，腓骨缩短> 2 mm，OA级进展和TTA≥2°的比率显着降低，并且FAOS和VAS评分均优于TP组（所有p <0.05）。OA的严重程度 TTA≥2°，远端螺钉松动与VAS评分呈正相关，与FAOS呈负相关。在治疗50岁以上患者的AO / OTA 44B骨折时，PLP可提供更好的VAS评分，FAOS和放射学结果，包括腓骨缩短> 2 mm更少，骨关节炎（OA）踝关节进展更少，植入物去除率更低以及更少经过一年的随访，TTA比TP≥2°。治疗级别III 经过1年的随访，与TP相比，≥2°的TTA更少。治疗级别III 经过1年的随访，与TP相比，≥2°的TTA更少。治疗级别III