Treatment of Isolated Lateral Malleolar Fractures Using Locking Compression Plate Fixation and Tension Band Wiring Fixation

Article information

J Musculoskelet Trauma. 2020;33(1):16-21
Publication date (electronic) : 2020 January 10
doi : https://doi.org/10.12671/jkfs.2020.33.1.16
Department of Orthopedic Surgery, Gwangju Veterans Hospital, Gwangju, Korea
Correspondence to: Woojin Shin, M.D. Department of Orthopedic Surgery, Gwangju Veterans Hospital, 99 Cheomdanwolbong-ro, Gwangsan-gu, Gwangju 62284, Korea Tel: +82-62-602-6162 Fax: +82-62-602-6936 E-mail: neolimp@naver.com
Received 2019 November 29; Revised 2020 January 03; Accepted 2020 January 03.

Abstract

Abstract

Purpose

The purpose of this study was to compare the clinical and radiological outcomes of locking compression plate (LCP)-screw fixation and tension band wiring (TBW) fixation in isolated lateral malleolar fractures.

Materials and Methods

From May 2016 to August 2018, 52 patients with isolated lateral malleolar fracture were retrospectively reviewed. They were divided into 30 cases of the LCP fixation group (Group I) and 22 cases of the TBW fixation group (Group II). The clinical and radiological results of those groups were compared. Pearson chi-square tests and independent t-tests were used in the statistical analysis.

Results

The mean length of the surgical incision was 8.3 cm in Group I and 4.9 cm in Group II. Radiological union was obtained at a mean of 8.4 weeks in both groups. The mean American Orthopaedic Foot and Ankle Society score was 90 (range, 85–97) and 92 (range, 85–100) in Groups I and II, respectively, at the last follow up.

Conclusion

Both the LCP-screw and TBW techniques revealed excellent results in isolated lateral malleolar fractures. The tension band technique may be a fine alternative method of fixation in the treatment of isolated lateral malleolar fracture.

Fig. 1.

(A) A 54-year-old female patient was diagnosed with isolated lateral malleolar fracture according to the simple radiography. (B) Surgical fixation with locking-plate screw on the postoperative radiography. (C) Bone-union was achieved within 12 months of surgery.

Fig. 2.

(A) A 32-year-old male patient was diagnosed with isolated lateral malleolar fracture according to the simple radiography. (B) Surgical fixation with the tension band wire on the postoperative radiography. (C) Bone-union was achieved within 12 months of surgery.

Baseline Characteristics and Demographics

Operation-Related Data Analysis

References

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Article information Continued

Fig. 1.

(A) A 54-year-old female patient was diagnosed with isolated lateral malleolar fracture according to the simple radiography. (B) Surgical fixation with locking-plate screw on the postoperative radiography. (C) Bone-union was achieved within 12 months of surgery.

Fig. 2.

(A) A 32-year-old male patient was diagnosed with isolated lateral malleolar fracture according to the simple radiography. (B) Surgical fixation with the tension band wire on the postoperative radiography. (C) Bone-union was achieved within 12 months of surgery.

Table 1.

Baseline Characteristics and Demographics

  Group I (plate-screw fixation) Group II (tension band wiring) p-valu
No. of patients 30 22 0.26
Sex (male/female) 18/12 14/8 0.79
Age (yr) 43 (27–73) 46 (26–76) 0.75
Follow-up periods (mo) 16 (12–19) 14 (12–16) 0.71
Total hospital periods (d) 18.5 (14–28) 14.2 (12–23) 0.08

Values are presented as number only or mean (range).

Table 2.

Operation-Related Data Analysis

  Group I (plate-screw fixation) Group II (tension band wiring) p-value
Operation time (min) 53.4 (47–64) 47.8 (42–62) 0.87
Radiologic union (wk) 8.2 (7.3–11.2) 8.7 (7.4–12.5) 0.80
Incision length (cm) 8.3 (6.6–8.5) 4.9 (5.6–6.7) 0.0031
Dissatisfaction (implant irritation) 6 0 0.03
Dissatisfaction 3 1 0.62
(incision scar)      
Mean of AOFAS score 90 (85–97) 92 (85–100) 0.88
>90 (n) 18 16  
80–89 (n) 6 6  

Values are presented as mean (range) or number only. AOFAS: American Orthopaedic Foot and Ankle Society.