Abstract:

BACKGROUND: The ankle is one of the most important joints of human body. Medial malleolar fractures are very common, and there are lots of surgical methods to treat it. A traditional approach is open reduction and internal fixation. As views changed, percutaneous cannulated screw internal fixation become increasingly popular, but various clinical studies are still needed to analyze the efficacy of these two methods.
OBJECTIVE: To compare the recovery of joint function after medial malleolus fracture repaired by open reduction and internal fixation and percutaneous cannulated screw fixation. 
METHODS: A total of 63 cases of medial malleolus fracture, who were treated in the Department of Orthopedics, People’s Hospital of Xinyi City from March 2009 to March 2013, were enrolled. According to repair plan, they were divided into two groups: open reduction and internal fixation group (n=29) and percutaneous cannulated screw fixation group (n=34). Ankle function was assessed in accordance with Kofoed ankle score standard on admission and at 3 months after repair.
RESULTS AND CONCLUSION: The patients were followed up for 3 to 12 months. Among 29 cases in the open reduction and internal fixation group, the wound was healed at grade A in 27 cases and at grade B in 2 cases; 29 cases were reset, and no poor reduction was found. In the percutaneous cannulated screw fixation group, 34 cases had healing at grade A, with the presence of good reduction. All patients experienced bone union, and no 
infection appeared. In accordance with Kofoed score, at 3 months of follow-up, the satisfaction rate was 97% in the open reduction and internal fixation group, and 100% in the percutaneous cannulated screw fixation group. These data suggest that both open reduction and internal fixation and percutaneous cannulated screw fixation for medial malleolus fracture obtained positive effects, but percutaneous cannulated screw fixation showed small surgical trauma, which could reduce the rate of infection and contributed to early functional recovery of ankle joint.

Key words: Ankle, Fractures, Bone, Bone Nails, Internal Fixators, Follow-Up Studies