目的 比较经腓骨入路及后外侧入路治疗旋后外旋型III～IV型踝关节骨折的疗效。方法 选取旋后外旋型III～IV型 踝关节骨折患者158例，根据手术入路方式分为A、B两组，A组61例行经腓骨入路内固定术，B组97例行后外侧入路 内固定术。比较两组手术时间、术中出血量、住院时间、骨折愈合时间及预后情况。结果 两组手术时间、住院时 间无明显差异(P＞0.05)；A组术中出血量少于B组，B组骨折愈合时间短于A组(P＜0.05)。B组AOFAS踝-后足评分高 于A组，整体预后情况优于A组(P＜0.05)。结论 后外侧入路较经腓骨入路治疗旋后外旋型III～IV型踝关节骨折效 果更好。

Objective To compare the efficacy of transfibular approach and posterolateral approach in the treatment of posterior external rotation of type III-IV ankle joint fractures. Methods A total of 158 patients with supination external rotation of type III-IV ankle joint fractures were selected and divided into group A and group B according to the surgical approaches. 61 cases in group A were given internal fixation via transfibular approach , and 97 cases in group B were given internal fixation via posterolateral approach. The operative time, intraoperative blood loss, hospital stay, fracture healing time and prognosis were compared between the two groups. Results There were no significant differences in the operative time and hospital stay between the two groups(P>0.05). The intraoperative blood loss in group A was lower than that in group B, and the fracture healing time in group B was shorter than that in group A(P<0.05). The ankle-hindfoot score of AOFAS in group B was higher than that in group A, and the overall prognosis was better than that in group A(P<0.05). Conclusion Posterolateral approach has better effects than transfibular approach in the treatment of supination external rotation of type III-IV ankle joint fractures.