title: Arthroscopy-assisted reduction versus open reduction in the fixation of medial malleolar fractures.
abstract: OBJECTIVE
  Purpose of this case-control study was to evaluate the feasibility and advantages of arthroscopically assisted reduction and internal fixation of isolated medial malleolar fractures and compare the outcomes with conventional open reduction and internal fixation.
  
  
  METHODS
  Forty-seven patients with medial malleolar fractures were grouped into two: arthroscopy-assisted group, and conventional open reduction and internal fixation group. Arthroscopic treatment group consisted of 21 patients. The mean age was 34 years (range: 22-49 years). Conventional open reduction and internal fixation group included 26 patients. The mean age was 42 years (range: 22-58 years). According to Herscovici system, 6 fractures in the arthroscopy group were classified as type-B, 13 fractures as type-C, and 2 fractures were classified as type-D. In both groups, fractures were classified according to Herscovici system. Radiological and clinical outcomes were evaluated according to van Dijk classification and Olerud-Molander scoring system, respectively.
  
  
  RESULTS
  The mean follow-up period was 26 months (18-52 months) for arthroscopically assisted group and 38 months (24-58 months) for the conventional group. According to van Dijk classification, there was only one patient with Grade 1 osteoarthritic changes in arthroscopically assisted group compared with the conventional group where two patients had Grade 2 and one patient had Grade 1 osteoarthritic changes. Median Olerud Scores were 92.3 (75-100) and 86.3 (70-100) for the arthroscopically assisted group and for the conventional group, respectively. The difference was statistically significant (p = 0.015).
  
  
  CONCLUSIONS
  With the use of arthroscopically assisted techniques in fixation of isolated medial malleolar fractures, surgeon can evaluate intra-articular surface and reduction that may be of value in the improvement in clinical outcomes over conventional surgical treatment.
  
  
  METHODS
  Case-control study, Level III.
authors: Department of Orthopaedics and Traumatology, Faculty of Medicine, Zonguldak Karaelmas University, Esenköy, Kozlu, Zonguldak, Turkey, dregementurhan@yahoo.com.
authors: Egemen
authors: E
authors: Turhan
authors: Mahmut Nedim
authors: MN
authors: Doral
authors: Murat
authors: M
authors: Demirel
authors: Ahmet Ozgur
authors: AO
authors: Atay
authors: Murat
authors: M
authors: Bozkurt
authors: Onur
authors: O
authors: Bilge
authors: Gazi
authors: G
authors: Huri
authors: Kivanc
authors: K
authors: Atesok
authors: Defne
authors: D
authors: Kaya
mesh_terms: D000328:Adult; D064386:Ankle Fractures; D001182:Arthroscopy / Q000379:methods* / Q000534:rehabilitation; D016022:Case-Control Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods* / Q000534:rehabilitation; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011182:Postoperative Care / Q000379:methods / Q000534:rehabilitation; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D055815:Young Adult