Cannulated screw and Kirschner fixation for the treatment of medial and lateral malleolar epiphyseal fractures in children: a retrospective study of 36 cases

Abstract

Background Percutaneous fixation with cannulated screws is an effective method for treating medial malleolar epiphyseal fractures, which comprise a portion of bimalleolar and trimalleolar fractures. Lateral malleolar fractures also need to be fixed to achieve anatomical reduction and absolute stable fixation of the ankle. However, there are no individual studies in the literature on this topic. Methods Thirty-six children (22 boys and 14 girls) aged 8 to 15 years (average, 11.3 years) with medial and lateral epiphyseal fractures were treated by cannulated screw and Kirschner fixation after closed reduction from January 2010 to December 2015 in our hospital. The patients were examined each month postoperatively. Ankle function was assessed using the Baird-Jackson ankle score. Results The 36 patients were followed up for 18 to 29 months (average, 25 months). No cases of fracture non-union or secondary displacement were observed, and the healing time was 2.8 ± 1.1 months (range, 2–4 months). At the last follow-up visit, the Baird-Jackson ankle score ranged from 83 to 100 (average, 94), including an “excellent” score in 13 cases, a “good” score in 19 cases, a “fair” score in 4 cases, and a “poor” score in 0 cases. The ankle recovered to the pre-injury level of function within 3.5 ± 1.6 months (range, 2–5 months). Dysfunction, pain, instability, and premature epiphyseal closure were not observed during the follow-up of the 36 patients. Conclusions Cannulated screw and Kirschner fixation after closed reduction is an effective and readily available method for the treatment of medial and lateral malleolar epiphyseal fractures in children.

Fractura de Tillaux

“…3,4 Tornillos canulados y alambres de Kirschner empleados en la fijación después de la reducción cerrada son útiles para fracturas epifisarias del maléolo lateral y medial en niños, los resultados confirmaron una alta tasa de unión y respuesta satisfactoria funcional sin complicaciones. 5 Por la…”

Outcomes of U-shaped internal fixation in the treatment of avulsion fracture of calcaneal tubercle

“…The maintenance of the plate and the fracture were evaluated by the routine anteroposterior and lateral imaging of the heel. The American Orthopaedic Foot and Ankle Association (AOFAS) score, Cedell score and the visual analog scale (VAS) were used to evaluate functional results [19][20][21].…”