Background: To evaluate the outcome of percutaneous fixation of lateral malleolar ankle fractures by intramedullary screw.Methods: Twenty-five patients with Weber A and Weber B displaced lateral malleolus fractures were retrospectively reviewed after they had done closed reduction and percutaneous internal fixation with an intramedullary fully threaded screw with a washer. A 3.5-mm, fully threaded, self- tapping bone screw. The length of the screw varies between 90 mm and 110 mm, depending on the fracture location and pattern.Results: All fractures united within an average time to union of 5.86 ± 1.74 weeks. There were no deep wound infections or complaints of painful hardware. At the latest follow-up, functional results were excellent in 16 patients (64%) good in 8 patients (32 %), fair in one patient (4%).Conclusion Percutaneous intramedullary screw fixation is a good easy technique in the management of lateral malleolar fracture that provides good clinical and radiological results as it is rapid, minimally invasive and without prominent hardware.
Background:A posteromedial tibial plateau fracture is considered a challenging injury pattern of the tibial plateau. Fracture line lies in the coronal plane leading to separation of a posteromedial fragment of variable size. This type of fracture is not rare, but it has been underappreciated previously.This study is aiming to spot light on posteromedial approach as new concept in treatment of tibial plateau fracture as regarding to clinical and radiological outcome and to assess its surgical efficacy and advantages in such cases and to show is it beneficial to the patients or not? Patient and Methods:This is a prospective study that included 15 consecutive patients (13 males & 2 females) with closed posteromedial tibial plateau fractures who had undergone open reduction and internal fixation through a posteromedial approach by plate and screws between May 2019 and September 2019. Our protocol in follow up ranged from three to six months postoperative. Results:In our study, the total clinical score according to the Rasmussen system was excellent in 8 patients (53.3%) and good in 7 patients (46.7%). As for complications, one case presented at the 3rd day postoperative with signs of compartment syndrome followed by superficial infection. The patient improved with conservative treatment with no need for surgical intervention. Conclusion:The posteromedial approach in managing posteromedial tibial plateau fracture is considered a safe and efficient approach. It allows perfect visualization and reduction of the displaced fragments. This approach uses an intermuscular plane without exposure of the neurovascular bundle.
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