Anterograde Headless Cannulated Screw Fixation in the Treatment of Medial Malleolar Fractures: Evaluation of a New Technique and Its Outcomes

• Published in: Medical principles and practice Vol. 25; no. 5; pp. 429 - 434
• Main Authors: Tekin, Ali Çağrı, Çabuk, Haluk, Dedeoğlu, Süleyman Semih, Saygılı, Mehmet Selçuk, Adaş, Müjdat, Büyükkurt, Cem Dinçay, Gürbüz, Hakan, Çakar, Murat, Tekin, Zeynep Nilüfer
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01-01-2016
• Subjects: Adult; Ankle Fractures - surgery; Bone Screws; Female; Fracture Fixation, Internal - methods; Fracture Healing - physiology; Humans; Male; Middle Aged; Original Paper; Headless cannulated screw; Medial malleolus; Anterograde fixation
• ISSN: 1011-7571; 1423-0151
• DOI: 10.1159/000447426

Objective: To evaluate the functional and radiological outcomes of anterograde headless cannulated screw fixation for medial malleolar fractures. Subjects and Methods: This study included 12 patients (8 males, 4 females; age 27-55 years) with medial malleolar type B fractures according to the Herscovici fracture classification who had undergone anterograde headless cannulated screw fixation surgery between 2012 and 2014. Seven had an isolated medial malleolar fracture and 5 a bimalleolar fracture. All of the bimalleolar fractures were classified as 44-B2 based on the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification. Postoperatively, bone union was evaluated on direct radiographs at the final follow-up examination. The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system was used for clinical evaluation. Results: The mean follow-up period was 17.2 ± 5.3 months (range 12-23). Full union was achieved in all fractures. The mean time to union was 3.4 ± 1.5 months (range 2-5). No instability, loss of reduction, non-union or infection was observed in any patient. The mean AOFAS score was 95.0 ± 5.4 (range 87-99). Based on the AOFAS score, 4 patients showed good results and 8 excellent results. The mean time to return to the previous level of activity was 4.0 ± 2.5 months (range 2-5). Conclusion: In this study, anterograde headless cannulated screw fixation yielded good clinical outcome in the surgical treatment of Herscovici type B fractures.