Percutaneous fixation versus open reduction and internal fixation in treatment of medial malleolus fracture

Abstract

Background: Medial malleolus fractures are common orthopedic injuries that require prompt and effective treatment. This study aimed to compare two treatment approaches, open reduction and internal fixation (ORIF) and closed reduction and percutaneous fixation (CRPF), for isolated medial malleolus fractures in adults. Methods: This randomized controlled trial included 30 patients with isolated medial malleolus fracture who were assigned to either the ORIF or CRPF group using a simple randomization method. Surgical procedures were performed as described in the study, and post-operative management included splinting and regular clinical assessments. Results: Intraoperatively, CRPF demonstrated significantly lower operative time (33±5 min vs. 50±11 min, P < 0.001) but higher X-ray exposure (33±9 vs. 25±7, P=0.014) compared to ORIF. Post-operatively, there were no significant differences between the two groups in terms of delayed union, pain with movement, soft tissue infection, or time to full union. Conclusions: Both ORIF and CRPF are viable treatment options for isolated medial malleolus fractures in adults. CRPF offers advantages in terms of shorter operative time but requires increased fluoroscopy usage. Level of Evidence: Level IV.