A comparative study of tension band wiring and cannulated screw fixation for medial malleolar fractures

Abstract

Background: Ankle fractures have been the subject of numerous studies and articles regarding the mechanism of injury, classification and treatment modalities.Objective: To compare the clinical, radiological and functional outcome of medial malleolar fracture management by cannulated screw fixation and tension band wiring.Methods: This is a randomized comparative study done on 40 patients between the age group of 15 to 65 years. The study period was from September 2013 to September 2015. Twenty patients each were treated with cannulated screw fixation and tension band wiring respectively. Outcome measure includes clinical and radiological union. Functional outcome was assessed by using modified ankle score of Olerud and Molander.Result: Radiological union was seen at 11.6 weeks for cannulated screw fixation and 9.2 weeks for tension band wiring [p value 0.03]. Based on our assessment parameters 80% had excellent to good outcome 20% had fair to poor outcome for cannulated screw fixation, where as 90% had excellent to good outcome and 10% had fair outcome for tension band wiring [p value 0.04].