Anterograde Headless Cannulated Screw Fixation in the Treatment of Medial Malleolar Fractures: Evaluation of a New Technique and Its Outcomes.
OBJECTIVE
To evaluate the functional and radiological outcomes of anterograde headless cannulated screw fixation for medial malleolar fractures.


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).


CONCLUSIONS
In this study, anterograde headless cannulated screw fixation yielded good clinical outcome in the surgical treatment of Herscovici type B fractures.
Department of Orthopaedics and Traumatology, Okmeydanı Training and Research Hospital, Istanbul, Turkey.
Ali Çağrı
AÇ
Tekin
Haluk
H
Çabuk
Süleyman Semih
SS
Dedeoğlu
Mehmet Selçuk
MS
Saygılı
Müjdat
M
Adaş
Cem Dinçay
CD
Büyükkurt
Hakan
H
Gürbüz
Murat
M
Çakar
Zeynep Nilüfer
ZN
Tekin
D000328:Adult; D064386:Ankle Fractures / Q000601:surgery*; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged