Bicortical fixation of medial malleolar fractures

Medial malleolar fractures occur commonly and are often treated surgically. For any given fracture, treatment depends on the fracture configuration, and the clinical scenario. Multiple fixation options exist, including cortical or cancellous screws, tension band wiring, plates and screws, and even suture anchors according to some reports. When using screws alone, bicortical fixation of the medial malleolus may be desirable. This is especially true in the population of patients who demonstrate osteopenia. We present a simple technique that facilitates insertion of bicortical screws in the fixation of medial malleolar fractures.