Lateral malleolar fractures Weber Type A and B: does percutaneous intramedullary screw confer a solid alternative to the traditional neutralization plate?

Int Orthop. 2022 Sep;46(9):2127-2134. doi: 10.1007/s00264-022-05425-x. Epub 2022 May 16.

Abstract

Purpose: To compare the clinical results, complication rates, and radiographic outcome between both methods of fixation of lateral malleolar fractures: lateral neutralization plates and intramedullary fully threaded screws.

Patients and methods: This prospective case series study involved 73 patients with fractured lateral malleolus of type A, B according to Weber classification, to whom internal fixation was performed by either lateral plate and screws construct (Group A) or intramedullary screw (Group B). All patients were followed up for 12 months at least, with an average follow-up time of 12.7 months.

Results: There was no significant difference in the functional outcome score between both groups. The intramedullary screw group had a significantly shorter operative time and time to full union (P<0.001 and =0.006 respectively). There was a relatively higher accuracy of reduction with the plate fixation group, but it was statistically insignificant. There was a relatively fewer complication rate with the use of intramedullary screw fixation compared to plate fixation.

Conclusion: The use of intramedullary fixation is a good alternative for plate fixation in low fibular fractures (Weber A and B). Although plate fixation provides an optimal anatomic reconstruction of the fractures, intramedullary fixation may have a lower risk of complications.

Keywords: Ankle fractures; Intramedullary screw fixation; Lateral malleolar fractures; ORIF.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ankle Fractures* / diagnostic imaging
  • Ankle Fractures* / surgery
  • Bone Plates / adverse effects
  • Bone Screws / adverse effects
  • Fracture Fixation, Internal / adverse effects
  • Fracture Fixation, Internal / methods
  • Fracture Fixation, Intramedullary* / methods
  • Humans
  • Retrospective Studies
  • Treatment Outcome