Comparison of cannulated screw, tension band, and mini-fragment t-plate fixation in medial malleolus fractures

Abstract

Background: The study aimed to compare the clinical results of cannulated screw (KS), tension band, and mini-fragment T-plate (MTP) fixation in medial malleolus fractures. Materials and Methods: The present study employed a retrospective cohort design to investigate the outcomes of patients who underwent treatment for medial malleolus fractures at our clinic between January 2016 and January 2019. A total of 90 patients were included in the study, and they received one of three fixation methods: cannulated screw, tension band, or mini-fragment T-plate. The evaluation of ankle and foot functions was conducted using the American Orthopedic Foot and Ankle Surgery score, number of fluoroscopy shots, duration of surgery, and ankle joint range of motion measurements. Results: After a 12-month follow-up, there was no significant difference between the groups (p=0,263, p=0,432 and P=0,376) in terms of the AOFAS score. The ankle joint range of motion was similar in all groups. According to the radiographs, the compression ability was weaker in the mini-plate group than in the other groups. The mean duration of surgery was shorter in the cannulated screw group (p<0.001). The mean number of scopy shots was not similar between the groups (p<0.001). One patient in the mini-fragment T-plate group developed a superficial infection and recovered with a 2-week oral antibiotic treatment. In the tension band group, one patient experienced skin problems successfully resolved with a one-week treatment regimen. Additionally, three patients treated with cannulated screws required screw removal after fracture union due to their dissatisfaction with screw prominence. No patient underwent revision surgery. Conclusions: The findings of the study revealed that patients treated with tension bands and cannulated screws demonstrated better clinical outcomes. However, it was observed that these techniques were less favorable compared to the mini-plate procedure due to their potential for tissue irritation.