ASSESSMENT OF OUTCOMES FOLLOWING TWO DIFFERENT FIXATION TECHNIQUES FOR MEDIAL MALLEOLUS FRACTURES: CANNULATED CANCELLOUS SCREWS VERSUS TENSION BAND WIRING

Abstract

Medial malleolus fractures are mutual ankle wounds that frequently need operative fixation to restore ankle stability, achieve fracture union, and facilitate early functional recovery. Cannulated Cancellous (CC) Screw fixation and Tension Band Wiring (TBW) are established surgical techniques; however, the optimal fixation method remains controversial because of differences in biomechanical properties, functional outcomes, and implant-related complications. A prospective comparative study was conducted at Sree Balaji Medical College and Hospital, Chennai, involving 30 patients with medial malleolus fractures. Patients underwent operative fixation using either CC Screw fixation (n = 15) or TBW (n = 15). Radiological fracture union, postoperative pain restrained via the Visual Analogue Scale (VAS), functional outcome restrained by the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score, postoperative complications, and secondary implant removal were evaluated over a minimum follow-up period of six months. Both groups achieved satisfactory fracture union, progressive pain reduction, and substantial functional development throughout follow-up. The CC Screw group demonstrated slightly shorter union time, lower VAS scores, higher AOFAS scores, and fewer implant-related complications than the TBW group. However, none of these alterations were statistically significant (p > 0.05). Hardware irritation and secondary implant removal occurred more frequently following TBW fixation. Both CC Screw fixation and TBW provided effective treatment for medial malleolus fractures, with comparable radiological, functional, and clinical outcomes. Implant selection should be individualised according to fracture morphology, bone quality, and intraoperative assessment.