Comparison between headless compression screws and tension band wires for the fixation of medial malleolar fractures: a prospective randomized trial
- Authors
- Park, Young Hwan; Cho, Hyun Woo; Choi, Jung Woo; Kim, Hak Jun
- Issue Date
- Oct-2022
- Publisher
- Springer Verlag
- Keywords
- Ankle fractures; Fracture fixation; Internal fixators; Trauma
- Citation
- Archives of Orthopaedic and Trauma Surgery, v.142, no.10, pp 2627 - 2633
- Pages
- 7
- Indexed
- SCIE
SCOPUS
- Journal Title
- Archives of Orthopaedic and Trauma Surgery
- Volume
- 142
- Number
- 10
- Start Page
- 2627
- End Page
- 2633
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/53768
- DOI
- 10.1007/s00402-021-04003-x
- ISSN
- 0936-8051
1434-3916
- Abstract
- Introduction
To date, there has been no prospective randomized trial supporting the rationale of the use of headless compression screw (HCS) compared to conventional fixation methods for medial malleolar fractures. This study aimed to prospectively compare the outcomes of the HCS and tension band wire (TBW) for the fixation of medial malleolar fractures.
Material and methods
Sixty patients were randomized to receive either an HCS or a TBW for the fixation of a medial malleolar fracture. Clinical outcomes were assessed using the Olerud–Molander ankle score (OMAS), EuroQoL five-dimensional instrument (EQ-5D) score, visual analog scale (VAS) score, patient satisfaction with implant-related symptoms, operative time, and incision length. Radiographic outcomes were assessed using the presence of nonunion, delayed union, and articular incongruity. Clinical and radiographic assessments were performed at 2 and 6 weeks and 3, 6, and 12 months postoperatively.
Results
The OMAS, EQ-5D score, VAS score, and operative time did not differ between the HCS and TBW groups; however, the HCS group had greater satisfaction with implant-related symptoms and smaller incision than the TBW group. There was no difference in the presence of nonunion, delayed union, and articular incongruity.
Conclusion
HCS fixation for medial malleolar fractures is not inferior to TBW fixation, while reducing implant-related symptoms. These findings suggest that HCS is a viable alternative for the fixation of medial malleolar fractures.
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- Appears in
Collections - 2. Clinical Science > Department of Orthopedic Surgery > 1. Journal Articles
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