Mini-Screws-Only Fixation Method for Small Fragments of Medial Malleolus Fractures

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Skeletal Repair

Background:

• Open reduction and internal fixation is standard for displaced medial malleolus fractures (MMFx).
• Traditional fixation methods (tension band wiring, unicortical screws) are suboptimal for small, difficult-to-manipulate MMFx fragments.
• A novel approach using mini-screws for small MMFx fragments is presented.

Purpose of the Study:

• To evaluate the efficacy and safety of mini-screw fixation for small fragment medial malleolus fractures.
• To assess clinical and radiographic outcomes in patients treated with this technique.

Main Methods:

• Retrospective study of nine patients with small fragment MMFx treated with mini-screws (April 2013 - March 2018).
• Clinical data, radiographic features, ankle range of motion, and symptomatic implants were reviewed.
• Functional outcomes assessed using the Foot and Ankle Outcome Score (FAOS).

Main Results:

• All nine MMFx healed without loss of reduction, nonunion, or implant failure.
• No incidental bone breakage occurred during surgery.
• Mean FAOS score was 80.99; no patients required hardware removal.

Conclusions:

• Mini-screw fixation is a straightforward and safe technique for comminuted medial malleolus fractures in young adults.
• Secure fixation of anterior and posterior colliculi minimizes implant irritation and the need for removal.