Medial malleolus fracture management- A comparative study between tension band wiring and cancellous screw fixation.

Volume 8 | Issue 1 | Jan – Feb 2020 | Page: 14-17  | Sagar Venkataraman, Prabhu Ethiraj, Arun Heddur Shanthappa Naik, Sandesh Agarawal

Authors: Sagar Venkataraman [1], Prabhu Ethiraj [1], Arun Heddur Shanthappa Naik [1], Sandesh Agarawal [1].

[1] Department of Orthopaedics, Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER) Tamaka, Kolar Karnataka INDIA.

Address of Correspondence
Dr. Prabhu Ethiraj
Associate Professor,Orthopaedics
Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER) Tamaka, Kolar Karnataka INDIA.


Background: Medial malleolus fracture is commonly seen nowadays in orthopaedic practice. There are different modalities of treatment based on fracture pattern, socio-economic status. Undisplaced fracture can be managed by cast application. Various surgical modalities of treatment are available in treating medial malleolus fracture like tension band wiring, cancellous screw or cortical screw fixation, plate fixation, k-wire, suture anchors. The purpose of our study was to evaluate and compare radiological outcome of medial malleolar fracture managed with tension band wiring and cancellous screw fixation.
Materials and Methods: Our study included 53 patients who met inclusion criteria and were divided into two groups. 25 patients with bimalleolar fractures cases were included in group 1 and treated with open reduction and tension band wiring (TBW) for medial malleolus fracture. Other 28 patients in group 2 were treated by open reduction/closed reduction with cannulated cancellous screw for medial malleolus fracture. In all the cases lateral malleolus was fixed and common factor in both the group. All post op patients were evaluated at 1st month, 2nd month, 3rd month, 6th month and 1 year. We evaluated patient clinically and radiological union of fractures.
Results: In our study out of 53 patients there was male preponderance and average age was 42.07 years. Right side fractures were more compared to left side fractures. Most common mode of injury was road traffic accident. Average union time in group 1 is 14.4 weeks and group 2 is 12.6 weeks. Fracture union was 100% in group 1 and in group 2 was 96.66%. All the data from the study was evaluated by Fischer exact test with P value calculated for union rates between two groups patient treated with Tension Band Wiring Vs Cannulated cancellous screw. P value <0.05 was considered statistically significant.
Conclusion: In our study average union time in patients treated with cancellous screw fixation was early compared to patients treated with tension band wiring group. In cancellous screw fixation group required additional stability in the form additional k-wire or second cancellous screw with ankle joint immobilization.
Key words: Medial malleolus, Tension Band Wiring (TBW), Cancellous screw.


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How to Cite this article: Venkataraman S, Ethiraj P, Naik A, Agarawal S | Medial malleolus fracture management- A comparative study between tension band wiring and cancellous screw fixation. | Journal Of Karnataka Orthopaedic Association | Jan-Feb 2020; 8(1): 14-17.

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