Das Nikhilesh, Mishra Suman S, Mohanty Anuraag, Sahoo Dhananjay
Department of Orthopaedics, Peerless Hospital and B.K. Roy Research Center, Kolkata, IND.
Department of Orthopaedics, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2025 May 10;17(5):e83869. doi: 10.7759/cureus.83869. eCollection 2025 May.
Medial malleolar fractures frequently accompany ankle fractures and demand precise anatomical reduction for optimal outcomes. Several fixation techniques have been employed, including partially threaded unicortical lag screws, which, despite their ease of use, are associated with reduced torque resistance and increased screw loosening. Alternatively, partially threaded cancellous screws with or without washers have also been utilized to achieve stable fixation in medial malleolar injuries.
This study aimed to evaluate and compare the radiological and functional outcomes of medial malleolar fractures in ankle fracture cases managed using headless compression screw fixation.
A total of 47 patients were included in this retrospective study conducted over a 30-month period. Preoperative assessments included detailed clinical histories, injury mechanism analysis, and imaging investigations. Postoperative follow-up extended to 30 months. Clinical outcomes were assessed using the Baird and Jackson Scoring System (BJS) and the American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot Score.
Among the 47 patients, 37 patients (78.7%) achieved AOFAS scores above 90, reflecting excellent functional outcomes, while 10 patients (21.3%) scored between 80 and 90, indicating good results. Additionally, 18 patients (38.2%) attained BJS scores greater than 95, corresponding to excellent outcomes in terms of pain relief, mobility, and radiological union.
Headless cannulated compression screw fixation demonstrates high efficacy in the treatment of medial malleolar fractures, offering a reliable alternative to conventional fixation techniques with favourable radiological and functional outcomes.
内踝骨折常伴随踝关节骨折，需要精确的解剖复位以获得最佳疗效。已经采用了几种固定技术，包括部分螺纹单皮质拉力螺钉，尽管其使用方便，但抗扭矩能力降低且螺钉松动增加。另外，也使用了带或不带垫圈的部分螺纹松质骨螺钉来实现内踝损伤的稳定固定。
本研究旨在评估和比较使用无头加压螺钉固定治疗的踝关节骨折病例中内踝骨折的放射学和功能结果。
本回顾性研究共纳入47例患者，研究时间为30个月。术前评估包括详细的临床病史、损伤机制分析和影像学检查。术后随访延长至30个月。使用贝尔德和杰克逊评分系统（BJS）以及美国矫形足踝协会（AOFAS）后足评分评估临床结果。
在47例患者中，37例（78.7%）的AOFAS评分高于90分，反映出优异的功能结果，而10例（21.3%）的评分在80至90分之间，表明结果良好。此外，18例（38.2%）的BJS评分大于95分，在疼痛缓解、活动度和放射学愈合方面对应优异结果。
无头空心加压螺钉固定在内踝骨折治疗中显示出高效性，为传统固定技术提供了可靠的替代方法，具有良好的放射学和功能结果。
