Vol. 7, Issue 3, Part B (2023)

Introduction: Most ankle injuries occur. The ankle is a complex joint; hence ankle fractures are frequent. Anatomy, soft tissue, and fracture fixation determine treatment. Malreduction may swiftly lead to end-stage degenerative joint disease. The best fixing method will prevent this and lead to the best fracture treatment. The aim of study tension band wire and cannulated screws in medial malleolus fixation are compared using modified Olerund and Molander grading system for clinical, radiological, and ankle functional outcomes. Method: This prospective randomised trial included 30 individuals aged 20-55, with the majority in their 30s. Tension band wire and two cannulated screws were used to treat closed medial malleolar fractures in half the sample. The patients were tested clinically and radiologically (6w-3 months and 6 months) and functionally (6months) using modified Olerund and Molander scoring method.

Results: Tension band wire union rate was quicker (10.5 weeks) than cannulated screws fixing (12w), with a p value of 0.045. Tension band wiring performed better than cannulated screws, confirming prior findings. We had limited complications: superficial wound infection (6.67%) in each group and delayed union (6.67%) in the cannulated screw group. Cannulated screws had one implant-related complication (6.67%). No deep infections, non-union, or implant failure occurred.

Conclusion: Tension band wiring may be more convincing fixation option for closed medial malleolus fracture as compared to cannulated screws fixation.