Comparative Study of Internal Fixation for Displaced Closed Fractureof Medial Malleolus Using Malleolar Screw Versus Tension-band Wiring

Al-Lamy,; A, W.; H, M.; Al-Obaidy,

	Comparative Study of Internal Fixation for Displaced Closed Fractureof Medial Malleolus Using Malleolar Screw Versus Tension-band Wiring
Kerbala Journal of Medicine
Article 1, Volume 2, Issue 3, 2009, Pages 308-318 PDF (0 K)
Authors
; W. A; M. H;
Abstract
in a prospective, randomized trial of 40 patients with displaced closed fracture of medial malleolus at Al-Sader, Al-Hakeem, Al-Manathera & private hospitals in Najaf from March 2005 to March 2008, we compared two methods of internal fixation namely malleolar screw and tension-band wiring. The patients were then allocated to two treatment groups (20 patients in each group). The populations of the groups were similar in age (median 37 years), sex, fracture type (Danis-Weber type B and C), and aetiology (twisting, fall or motor vehicle accident). The patients were evaluated clinically, radiologically, and functionally with follow-up for average of one year. Radiological union took place in the group treated with tension-band (mean time 9.4 weeks) earlier than those treated with malleolar screw (mean time 11.8 weeks) (p=0.03). Excellent and good results were achieved in 80% with malleolar screw fixation and in 90% with tension-band wiring (p=0.049). Although better range of motion was noticed in the group treated with malleolar screw, it did not reach significance level (p=0.628). The preliminary results of the current study suggest that tension-band wiring may be more valid option than malleolar screw for internal fixation of medial malleolar fractures.

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