A comparative study of three commonly used fixation techniques for isolated medial malleolus fracture

Kochai, Alauddin; Türker, Mehmet; Çiçekli, Özgür; Özdemir, Uğur; Bayam, Levent; Erkorkmaz, Ünal; Sukur, Erhan

doi:10.5606/ehc.2018.61449

Cited by 11 publications

(8 citation statements)

References 19 publications

(31 reference statements)

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“…A few studies suggest the use of titanium headless compression screws to eliminate the need for implant removal in MM fractures. The authors argued that the headless screws did not cause implant-related irritation findings because the screws were fully countersunk into the bone [28][29][30]. Similarly, the headless design of Mg screws appears to be advantageous.…”

Section: Discussionmentioning

confidence: 99%

Bioabsorbable magnesium screw versus conventional titanium screw fixation for medial malleolar fractures

et al. 2020

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Background It is still unknown whether bioabsorbable magnesium (Mg) screws provide an advantage over titanium screws in the treatment of medial malleolar (MM) fractures. The purpose of this retrospective study is to compare the clinical and radiological outcomes of MM fractures fixed with either bioabsorbable Mg screws or conventional titanium screws. Materials and methods A cohort of 48 patients with MM fractures who underwent compression screw fixation was retrospectively reviewed. Twenty-three patients (16 male, 7 female; mean age: 37.9 ± 17.7 years) were treated with bioabsorbable Mg screws, and 25 patients (14 male, 11 female; mean age: 45.0 ± 15.7 years) were treated with conventional titanium screw fixation. All patients were followed up for at least 1 year, with a mean time of 24.6 ± 10.5 months (12–53 months). The American Orthopedic Foot and Ankle Society (AOFAS) scale was used to evaluate the clinical results. The Kellgren–Lawrence (KL) osteoarthritis grading was used to evaluate posttraumatic osteoarthritis on final ankle radiographs. Fracture union, rate of implant removal, and complications were recorded. Comparative analysis of two independent groups was performed using the chi-squared test and the Mann–Whitney U-test. Results The two groups were comparable concerning demographic and clinical characteristics. Age (p = 0.146), sex (p = 0.252), side (p = 0.190), MM fracture type (p = 0.500), associated fractures (p = 0.470), and follow-up period (p = 0.903) were similar between the groups. At final follow-up examination, AOFAS score (p = 0.191) was similar between groups. Fracture union was achieved in all cases. Grade of posttraumatic osteoarthritis, according to KL, was equally distributed in both groups (p = 0.074). No deep infection or osteomyelitis was seen. Five patients in the titanium screw group underwent implant removal, due to pain in three of them and difficulty in wearing shoes in the other two (p = 0.031). Implant removal was performed after a mean of 14.2 ± 3.1 months (12–19 months). Conclusions Bioabsorbable Mg and titanium screws had similar therapeutic efficacy in MM fracture fixation regarding functional and radiological outcomes. However, the rate of implant removal was higher with titanium screws. Bioabsorbable Mg screws may be a favorable fixation option since secondary implant removal procedures can be prevented. Level of evidence Level IV, Retrospective case series.

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Section: Discussionmentioning

confidence: 99%

Bioabsorbable magnesium screw versus conventional titanium screw fixation for medial malleolar fractures

et al. 2020

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“…This study aimed to compare the efficacy of three common surgical approaches for medial malleolar fractures: tension band wiring, modified tension band wiring, and fully threaded cannulated cancellous screws, involving 99 cases divided into three groups of 33 each. The study sought to identify the superior method among these, as previous research, including studies by Badgire et al [5] and Kochai et al [9], had not conclusively done so.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Tension Band Wiring, Modified Tension Band Wiring and Fully Threaded Cannulated Cancellous Screws for Fixation of Medial Malleolus Fractures

SANTOSH S BORKAR,

SHIVRAJ S KONDE,

RAJIV MUNDE

et al. 2024

Asian J Pharm Clin Res

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Objective: To compare the three most commonly used fixation techniques: “Tension band wiring, modified tension band wiring, and fully threaded cannulated cancellous screws for fixation of medial malleolus fractures.” Methods: A prospective comparative cohort study was carried out at a tertiary care hospital in rural Maharashtra. Patients were allocated into three groups, with 33 patients in each group. The internal fixation was done by tension band wiring, modified tension band wiring, or fully threaded cannulated cancellous screws, depending on the group to which a patient belonged. Patients were assessed using the Baird and Jackson scoring system at each follow-up at immediate post-operative period, at 3, 6, 12, 24 weeks, and 1 year. For statistical purposes, p<0.05 was considered statistically significant. Results: There was no significant difference in the three groups as regards age, body mass index, and mean time from injury to management. The most common mode of injury was road traffic accidents (51.52%), followed by falls from height (27.27%) and sports-related injuries (21.21%). The mean duration of surgery was significantly longer in cases managed by tension band wiring as compared to the other two groups. Implant-related complications were significantly less in the threaded cannulated cancellous screw group as compared to the other two groups. Overall excellent to good outcomes were observed in 97% of cases of cannulated cancellous screws as well as in modified tension band wiring and 84.8% of cases of tension band wiring, respectively. Conclusion: Fully threaded cannulated cancellous screws or modified tension band wiring should be used for the management of medial malleolar fractures while considering the functional outcome and complications associated with each and patient-related factors.

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“…Open reduction with internal fixation, on the other hand, it is a great approach for restoring normal anatomy and biomechanics of the joint. A 4mm cannulated cancellous screw with a washer is the most common fixation approach for the medial malleolus, while a 1/3rd tubular plate is the most common fixation method for the lateral malleolus, according to Kochai et al [25].…”

Section: Discussionmentioning

confidence: 99%

Result of Ankle Fracture Fixation, Our Hospital Experience

Shah

Ahmed

Khanzada³

et al. 2021

JPRI

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Aims and Objectives: The goal of this study was to see the outcome of open reduction and internal fixation for ankle fractures. Methods: A prospective analysis of 40 ankle fractures of adult patients handled surgically using diverse approaches in the period from January 2019 to January 2020 at the Orthopedic department of SMBBIT, Dow University of Medical and Health Sciences. Karachi Pakistan. The ankle grading system developed by Baird and Jackson was used to assess the functional result. Results: We achieved 87.5 percent outstanding to good outcomes, 6.3 percent fair outcomes, and 6.2 percent bad outcomes in our study. The findings were comparable to those of other researchers around the world. Interpretation and Conclusion: In 87.5 percent of patients, the operational results were satisfactory, with good to outstanding functional outcomes. With stable fracture fixation, excellent outcomes are attained. Cancellous screws are better for internal fixation of the medial malleolus, while Malleolar screws are superior for that task. For ankle fractures treated surgically, patients may expect to have satisfactory function thereafter.

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A comparative study of three commonly used fixation techniques for isolated medial malleolus fracture

Cited by 11 publications

References 19 publications

Bioabsorbable magnesium screw versus conventional titanium screw fixation for medial malleolar fractures

Bioabsorbable magnesium screw versus conventional titanium screw fixation for medial malleolar fractures

Comparative Study of Tension Band Wiring, Modified Tension Band Wiring and Fully Threaded Cannulated Cancellous Screws for Fixation of Medial Malleolus Fractures

Result of Ankle Fracture Fixation, Our Hospital Experience

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