title: Percutaneous cannulated screw fixation for pediatric epiphyseal ankle fractures.
abstract: BACKGROUND
  Ankle injuries are among the most common injuries in children. The aim of this study was to compare the efficacies of two percutaneous fixation methods after closed reduction in physeal ankle fractures.
  
  
  METHODS
  We reviewed the cases of 24 patients with a mean age of 12.29 years; 16 were male, and 8 were female. Only patients with fractures of Salter-Harris types 2, 3, and 4 with displacements greater than 2 mm were included in the study. Patients were treated with closed reduction manipulation and percutaneous screw fixation. For each patient, either cannulated or headless full threaded compressive screws were used for percutaneous fixation. Radiological and clinical healing time, range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS) score and physeal arrest were then measured.
  
  
  RESULTS
  The mean follow-up time was 13 months. The mean time until cast removal was 3.5 weeks (range 2-5). A full ROM was achieved at an average of 5.7 weeks postoperatively (range 4-8). The radiologic healing time was 6.1 weeks (range 4-7). The patients' clinical healing time averaged 6.8 weeks (range 5-8). Differences in radiologic healing time (p = 0.487), clinical healing time (p = 0.192), AOFAS score (p = 0.467), and complication rate (p = 0.519) between patients who received the headless compressive screw and those who received the cannulated screw for fixation were not statistically significant.
  
  
  CONCLUSIONS
  We demonstrate good clinical results with closed reduction and the percutaneous screw fixation method. Both cannulated and headless compressive screws can be used safely as a treatment method in physeal ankle fractures.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Sakarya Training and Research Hospital, Sakarya, Turkey.
authors.forename: Özgür
authors.identifier: 0000-0001-8063-6866
authors.initials: Ö
authors.lastname: Çiçekli
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Güzelali
authors.initials: G
authors.lastname: Özdemir
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Sakarya University School of Medicine Training and Research Hospital, Sakarya, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Uysal
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Yenimahalle Training and Research Hospital, Ankara, Turkey.
authors.forename: Vedat
authors.initials: V
authors.lastname: Biçici
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, 29 Mayıs State Hospital, Ankara, Turkey.
authors.forename: İzzet
authors.initials: İ
authors.lastname: Bingöl
keywords: Ankle; Cannulated screw; Headless compressive screw; Physeal arrest; Physeal fractures