Isolated Medial Malleolus Fractures: Conventional Techniques Versus Headless Compression Screw Fixation

The aim of the present study was to evaluate the clinical and radiologic results of surgically treated isolated medial malleolar fractures and compare the clinical and radiologic results of the fixation methods of headless cannulated fully threaded compression screws and cancellous lag screws and tension band wiring. We included 32 patients who attended the final follow-up examination. Group 1 consisted of 11 patients (34.4%) treated with headless cannulated fully threaded compression screws. Group 2 consisted of 10 patients (31.2%) treated with cancellous lag screws. Group 3 consisted of 11 patients (34.4%) treated with Kirschner wires and intraosseous tension wiring. Standard ankle radiographs, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, and visual analog scale for pain were assessed. No statistically significant differences were found among the groups in regard to age, gender, preoperative fracture type, follow-up time, radiologic bone union time, and baseline AOFAS scale scores. The interval to fracture healing was 2.2 ± 0.42 months in group 1, 2.5 ± 0.71 months in group 2, and 2.45 ± 0.52 months in group 3. The AOFAS ankle-hindfoot scale score was 96.73 ± 5.55 in group 1, 93.1 ± 5.43 in group 2, and 93.73 ± 5.52 in group 3. Hardware removal was not required in any patient in group 1 but was required in 2 patients (20%) in group 2 and 3 patients (27.3%) in group 3. The visual analog scale score for pain on palpation at the medial malleolus was significantly lower statistically in the headless compression screw group (group 1; p = .003).