title: A comparative study in fixation methods of medial malleolus fractures between tension bands wiring and screw fixation.
abstract: OBJECTIVE
  The aim of this study is to compare two methods of internal fixations of fractured medial malleolus which are simple screw fixation and tension band wiring.
  
  
  METHODS
  Over 5 years we grouped 20 patients with fractured medial malleolus into two groups of operative treatments, group1 treated by malleolar screw fixation and group2 by tension band wiring. The patients were with same age group, gender, fracture type, and etiology. We use statistical analysis for make a comparative study between the two ways of surgical treatment.
  
  
  RESULTS
  The mean time for radiologic bone union was 11.8 weeks in group1 patients and 9.4 weeks in group2 patients (P = 0.03). No patients had any sign of fixation failure or Kirschner wires migration. According to the modified ankle scoring system of Olerud and Molander, excellent and good results were achieved in 80 % in group1 patients and 90 % in group2 patients (P = 0.049).
  
  
  CONCLUSIONS
  Tension-band wiring may be better treatment option for internal fixation of medial malleolar fractures than screw fixation.
  
  
  CONCLUSIONS
  From these findings we recommend a further randomized clinical trial of larger number of cases and longer follow-up duration in order to regard tension-band wiring a better operative option for fixation of medial malleolar fractures.
authors.affiliation: Department of Surgery, College of Medicine, University of Anbar, Al-Anbar, Iraq ; Al-Ramadi Teaching Hospital, Al-Ramadi, Iraq ; Al-Anbar Orthopedic Training Center, Al-Anbar, Iraq.
authors.forename: Ayyoub A
authors.initials: AA
authors.lastname: Mohammed
authors.affiliation: Al-Yarmook Teaching Hospital, Baghdad, Iraq.
authors.forename: Khalid Ahmed
authors.initials: KA
authors.lastname: Abbas
authors.affiliation: Al-Yarmook Teaching Hospital, Baghdad, Iraq.
authors.forename: Ammar Salah
authors.initials: AS
authors.lastname: Mawlood
keywords: Ankle; Fracture; Screw; Tension band