A study of functional outcome of bimalleolar fracture treated with fully threaded 4 mm cancellous cannulated screw in medial malleolus fracture
Aim: To analyse the functional outcome of Medial malleoli after Internal Fixation of medial malleolar fracture with fully threaded 4 mm cancellous cannulated screws.
Introduction: Ankle fractures are one of the commonest fractures encountered by an orthopaedic surgeon with the majority being treated with open reduction and tension band wiring but it has a midterm and long term complications like hardware prominence, low-grade infection and hardware removal. Purpose of this study on medial malleolus fracture is to evaluate functional outcome after open reduction and fully threaded 4 mm cancellous cannulated screw fixation which has a very low complication rate.
Materials and Method: This is a prospective study done in c u shah medical college and hospital Surendranagar. In the present study 30 cases of bimalleolar ankle fracture.Common Mechanism of Injury was Road traffic accidents and fall from height. the diagnosis was confirmed by Anteroposterior, lateral and Mortise radiograph. Classifications used are Lauge-Hanse Classification and DenisWeber Classification. Fully threaded 4 mm Cannulated cancellous screw was used for medial malleolus fixation.The anatomical plate used for fibula fixation.
Post-op protocol: Postoperatively limb were immobilized in a plaster splint for 6 weeks and limb were elevated.
Results: According to Baird and Jackson scoring system out of 30 cases, 56.67% were excellent and 26.67% were good, 13.34% were fair and 3.32% were poor.
Conclusion: Open reduction and tension band wiring fixation of medial malleolus has biomechanically proved stable fixation but it has a midterm and long term complications like hardware prominence, low-grade infection and hardware removal. The current study has studied that open reduction and fully threaded 4 mm cancellous cannulated screw in medial malleolus fracture have a comparable functional outcome with a low complication rate.
I, Davidovitch Egol AK. Ankle Fractures: In: Bucholz WR, Charles, Heckman JD, Paultornetta, Editors. Rockwood and Greens Fractures in Adults. Lippincott Williams and Wilkins Publishers.7th Ed; Philadelphia:2009:19752017.
AO. Manual of Principles of fracture fixation. 1:249-254.
Mack D, Szabo RM. Complications of tension-band wiring. J Bone Joint Surg. 2005;67(9):1936-1941.
Rovinsky D, Haskell A, Liu Q, Paiement GD, Robinovitch S. Evaluation of a new method of small fragment fixation in a medial malleolus fracture model. J OrthopTrauma. 2000;14(6):420-425. doi: https://doi.org/10.1097/00005131-200008000-00007.
Singh R, Pandey A, Sharma G. Functional results of bimalleolar ankle fractures treated by plating and Tension band wiring technique: A prospective study. Int J Orthop. 2019;5(3):379-382.doi: https://doi.org/10.22271/ortho.2019.v5.i3g.1556.
Maruthi CV, Shivanna. Closed intramedullary interlocking nailing for fracture shaft of femur: Prospective study. Int J Orthop. 2017;3(1):602-604.doi: https://doi.org/10.22271/ortho.2017.v3.i1i.89.
Mohapatra A, Raj K. Functional outcome after surgical treatment of ankle fracture using Baird Jackson score. Int J Res Orthop. 2018;4(4):638-641. doi: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20182738.
Roberts RS. Surgical treatment of displaced ankle fractures. Clin Orthop Relat Res. 1983;172:164-170.
Parvataneni Prathap DA, Kondlapudi A, Hariprasad S. Functional outcome in surgical management of Bimalleolar fractures in adults. Int J Orthop. 2016;2(4):72-76. doi: https://doi.org/10.22271/ortho.2016.v2.i4b.11.
Alam N, Parviz S. Comparative study of malleolar fractures by tension-band and malleolar screw. BOS J. 2007;12(1):13-19.
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