Cross-Screw Fixation in Isolated Medial Malleolar Fractures

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Background:

• Isolated medial malleolar fractures are less common than other ankle fracture types.
• Effective treatment aims for anatomical reduction, stable healing, and restored ankle function.
• Cross-screw fixation is a surgical technique for addressing these fractures.

Purpose of the Study:

• To evaluate the clinical and radiological outcomes of isolated medial malleolar fractures treated with cross-screw fixation.
• To assess fracture union, functional recovery, and pain levels post-treatment.

Main Methods:

• A cohort of 13 patients (9 males, 4 females) with isolated medial malleolar fractures underwent cross-screw fixation.
• Fracture union was assessed at 3 months post-surgery using radiographs.
• Functional outcomes were measured using the American Orthopaedic Foot and Ankle Scale (AOFAS) ankle score.

Main Results:

• At 3 months post-surgery, the mean AOFAS score was 82 (2 excellent, 9 good, 2 fair).
• By 24 months, the mean AOFAS score improved to 92.2 (11 excellent, 2 good).
• Mean VAS pain scores were 2 at 3 months and 0.6 at 24 months post-surgery.

Conclusions:

• Cross-screw fixation is a viable treatment option for isolated medial malleolar fractures.
• This technique results in less soft-tissue damage due to percutaneous application and a low-profile screw head.
• It potentially eliminates the need for additional Kirschner wires to prevent rotational deformity.