The Effect of Percutaneous Screw Fixation of Lateral Malleolus on Ankle Fracture Healing and Function

Abstract

Purpose: To measure the effectiveness of using percutaneous intramedullary screw fixation of the lateral malleolus fracture on the healing and functional outcome of ankle fracture. Materials and Methods: Forty-six patients with Weber A and low Weber B displaced lateral malleolus fractures who underwent closed reduction and percutaneous internal fixation with an intramedullary, fully threaded, screw were retrospectively reviewed. A 3.5-mm, fully threaded, selftapping bone screw (stainless steel from Pelvic Set Synthes). The length of the screw varies between 100 mm and 120 mm, depending on the fracture location and pattern. Results: All fractures united within an average time to union of 8.2 weeks. In all patients the average time to full weight bearing was 6.8 weeks, whereas that in patients with isolated lateral malleolus fractures was 4.5 weeks. There were no deep wound infections or complaints of painful hardware. At latest follow-up, functional results were excellent in, 25 patients (54.3%) good in 20 (43.5%), fair in (2.2%). Conclusion: If reduction of the lateral malleolus fracture can be obtained in a closed fashion (with the aid of an image x-ray intensifier), we believe that fixation may be performed with an axial screw percutaneously. This technique is quick, safe and easy to do with less complication.