Abstract
BackgroundPercutaneous fixation with cannulated screws is an effective method for treating medial malleolar epiphyseal fractures, which comprise a portion of bimalleolar and trimalleolar fractures. Lateral malleolar fractures also need to be fixed to achieve anatomical reduction and absolute stable fixation of the ankle. However, there are no individual studies in the literature on this topic.MethodsThirty-six children (22 boys and 14 girls) aged 8 to 15 years (average, 11.3 years) with medial and lateral epiphyseal fractures were treated by cannulated screw and Kirschner fixation after closed reduction from January 2010 to December 2015 in our hospital. The patients were examined each month postoperatively. Ankle function was assessed using the Baird-Jackson ankle score.ResultsThe 36 patients were followed up for 18 to 29 months (average, 25 months). No cases of fracture non-union or secondary displacement were observed, and the healing time was 2.8 ± 1.1 months (range, 2–4 months). At the last follow-up visit, the Baird-Jackson ankle score ranged from 83 to 100 (average, 94), including an “excellent” score in 13 cases, a “good” score in 19 cases, a “fair” score in 4 cases, and a “poor” score in 0 cases. The ankle recovered to the pre-injury level of function within 3.5 ± 1.6 months (range, 2–5 months). Dysfunction, pain, instability, and premature epiphyseal closure were not observed during the follow-up of the 36 patients.ConclusionsCannulated screw and Kirschner fixation after closed reduction is an effective and readily available method for the treatment of medial and lateral malleolar epiphyseal fractures in children.
Highlights
Percutaneous fixation with cannulated screws is an effective method for treating medial malleolar epiphyseal fractures, which comprise a portion of bimalleolar and trimalleolar fractures
Over a period of 6 years, 36 children with medial and lateral malleolar epiphyseal fractures were treated with cannulated screw and Kirschner fixation after closed reduction in our hospital and were followed up for an average of 2.1 years. We present their outcomes to evaluate the clinical effects of cannulated screw and Kirschner fixation after closed reduction for the treatment of medial and lateral malleolar epiphyseal fractures in children
The cannulated screws and Kirschner wires were extracted at 2.8 ± 1.1 months after surgery when the fractures had healed
Summary
Percutaneous fixation with cannulated screws is an effective method for treating medial malleolar epiphyseal fractures, which comprise a portion of bimalleolar and trimalleolar fractures. Malleolar epiphyseal fracture is one of the most common clinical injuries of the ankle joint, accounting for approximately 11% of epiphyseal injuries in children [1,2,3]. It is considered a “threatening fracture” because the injury mechanism of the distal epiphysis of the tibia and fibula is very complex, and many ankle ligaments are attached at the medial and lateral malleoli. Several types of implants have been used for the anatomical reduction of malleolar epiphyseal fractures, including Kirschner wires, metallic screws, and bioabsorbable screws [4, 9, 10]. Kirschner wires are typically used to assist in fracture reduction and
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
