Comparison of cannulated screw, tension band, and mini-fragment t-plate fixation in medial malleolus fractures

Year 2023, Volume: 2 Issue: 2, 36 - 41, 31.08.2023

İsmail Güzel Serkan Akpancar

https://doi.org/10.58651/jomtu.1325159

Abstract

Background: The study aimed to compare the clinical results of cannulated screw (KS), tension band, and mini-fragment T-plate (MTP) fixation in medial malleolus fractures.
Materials and Methods: The present study employed a retrospective cohort design to investigate the outcomes of patients who underwent treatment for medial malleolus fractures at our clinic between January 2016 and January 2019. A total of 90 patients were included in the study, and they received one of three fixation methods: cannulated screw, tension band, or mini-fragment T-plate. The evaluation of ankle and foot functions was conducted using the American Orthopedic Foot and Ankle Surgery score, number of fluoroscopy shots, duration of surgery, and ankle joint range of motion measurements.
Results: After a 12-month follow-up, there was no significant difference between the groups (p=0,263, p=0,432 and P=0,376) in terms of the AOFAS score. The ankle joint range of motion was similar in all groups. According to the radiographs, the compression ability was weaker in the mini-plate group than in the other groups. The mean duration of surgery was shorter in the cannulated screw group (p<0.001). The mean number of scopy shots was not similar between the groups (p<0.001). One patient in the mini-fragment T-plate group developed a superficial infection and recovered with a 2-week oral antibiotic treatment. In the tension band group, one patient experienced skin problems successfully resolved with a one-week treatment regimen. Additionally, three patients treated with cannulated screws required screw removal after fracture union due to their dissatisfaction with screw prominence. No patient underwent revision surgery.
Conclusions: The findings of the study revealed that patients treated with tension bands and cannulated screws demonstrated better clinical outcomes. However, it was observed that these techniques were less favorable compared to the mini-plate procedure due to their potential for tissue irritation.

Keywords

Medial malleolus, Fracture, Cannulated screw, Tension band, Mini plate, Aofas

Medial malleol kırıklarında kanüle vida, gergi bandı ve minifragment t-plak fiksasyonun karşılaştırılması

Abstract

Amaç: Çalışmamızın amacı medial malleol kırıklarında kanüle vida, gergi bandı ve minifragment t-plak fiksasyonun klinik sonuçlarının karşılaştırılmasıdır.
Materyal ve Metot: Çalışmamız retrospektif kohort çalışması olarak planlandı. Ocak 2016 ile Ocak 2019 yılları arasında kliniğimizde medial malleol kırığı nedeniyle kanüle vida, gergi bandı ve minifragment t-plak fiksasyonu ile tedavi edilen 90 hasta çalışmaya dahil edildi. Hastalar ayak bileği ve ayağın işlevini değerlendirmek için American Orthopaedic Foot and Ankle Surgery skoru, skopi sayısı, ameliyat süresi, ayak bileği eklem hareket açıklığı değerleri kullanılarak karşılaştırıldı.
Bulgular: 12 aylık takip sonrasında her gruplar arası AOFAS skorunda anlamlı fark görülmedi (p=0.263, P=0,432 ve P=0,376). Ayak bileği eklem hareket açıklığının tüm gruplarda benzer olduğu görüldü. Çekilen grafilerde kompresyon yeteneğinin miniplak grubunda diğer gruplara göre daha zayıf olduğu görüldü. Ortalama ameliyat süresinin kanüle vida grubunda daha kısa olduğu görüldü (p<0.001). Ortalama floroskopi uygulama sayısının gruplar arasında benzer olmadığı görüldü (p<0.001). Çalışmamızda Minifragment T-plak grubunda 1 hastada 2 haftalık oral antibiyotik tedavisi ile iyileşen yüzeyel enfeksiyon, Gergi bandı grubunda 1 hastada 1 haftalık tedaviye cevap veren deri problemleri gelişti. Kanüle vida ile tedavi edilen 3 hastada ise vida basısından dolayı memnuniyetsizlik oluştuğu için kaynama sonrası vidaları çıkarıldı. Hiçbir bir hastaya revizyon cerrahisi uygulanmadı.
Sonuç: Gergi bandı ve kanüle vida yapılan hastalarda daha iyi klinik sonuçlara sahip olduğunu fakat doku irritasyonu açısından mini plağa göre dezavantajlı olduğu görülmektedir.

Keywords

Medial malleol, Kırık, Kanüle vida, Gergi bandı, Mini plak, Aofas

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