Hook Plate Fixation of Medial Malleolar Fractures: A Comparative Study of Clinical Outcomes

Medial malleolar fractures, occurring in isolation or in bi- or trimalleolar fractures, require surgical fixation if there is any displacement. Several techniques have been described in the literature for open reduction and internal fixation of medial malleolar fractures, but no data exist on the functional outcomes after fixation with a hook plate. The objective of this review study was to compare complication and union rates in patients who underwent hook plate fixation of medial malleolar fractures to those who underwent fixation with 2 lag screws. A total of 31 patients were included in the study. They were all followed for a minimum of 6 months from the day of surgery. There was a 18% to 35% complication rate with this technique; however, there was no statistical difference in the complication rate between medial malleolar fracture fixation with hook plate versus 2 lag screws in our study. All patients in this study went on to have a successful union. Hook plate fixation is an acceptable alternative to medial malleolar fracture fixation, especially in patients at high risk for poor bone healing.