Abstract:  Objective    To compare the effect of different fixation direction of posterior lateral approach on ankle fracture.    Methods    Forty-eight patients, including 20 males and 28 females, aged (51.88 ± 7.90) years old, 20 left ankles and 28 right ankles were collected for posterior malleolus fractures fixation by posterior lateral approach in floating position, respectively. According to the classification of Lauge-Hansen fracture of ankle joint, 36 cases had supination-extorsion and 12 had pronation-abduction. All posterior malleolus were fixed with screws, including 22 cases in the forward to backward fixation group and 26 cases in the backward to forward fixation group. The time of incision healing and complications, fracture healing time, the last follow-up were evaluated by AOFAS score and operation time between two groups were compared.    Results    Patients in the two groups were followed up for 10-20 months, with an average of (13±3.5) months. All patients were healed at stage I, there was no incisional infection, blood vessel and nerve damage. There was no statistical difference in operation time, fracture healing time, AOFAS score (P>0.5). Conclusions    The posterior lateral approach for fixation of posterior malleolus fractures has a good effect. Different screw fixation directions have similar clinical results,  so surgeons can choose the appropriate method based on their experience.

Key words:  , Ankle fractures,  ,  , Posterior malleolar fractures,  ,  , Screw fixing