Comparison of Two Different Implants in Medial Malleolus Fracture.

BACKGROUND: We compared two different techniques used in medial malleolus fracture. It has been hypothesized that the hook plate technique, which has become widespread in recent years, may have an advantage over cannulated screws.

METHODS: Preoperative and postoperative data for medial malleolus fractures operated on between 2010 and 2020 were analyzed retrospectively. Patients were divided into those operated on with a hook plate (n = 20) and those operated on with compression screws (n = 20) and were compared in terms of complications, pain, functional recovery, union success, and ankle joint range of motion. Fracture union times were recorded.

RESULTS: Between groups, there were no significant differences in time to fracture union, pain, range of motion, and American Orthopaedic Foot and Ankle Society score (P = .420). Handling of the implant in a very weak patient in the hook plate group and revision in the cannulated screw group were the differences in complications between groups. The use of hook plates in a patient with medial malleolus fracture with metaphyseal fracture provided significant convenience in osteosynthesis.

CONCLUSIONS: Use of hook plates provides serious advantages to the surgeon in medial malleolus fractures with small or fragmented fragments and combined with malleolus metaphyseal fractures. Having a larger implant versus a cannulated screw is seen as a disadvantage, but screwing the implant close to the cortex increases its strength. Therefore, its use should be given priority in patients who are mentally unable to weightbear after surgery. Although hook plate is advantageous compared with cannulated screw in appropriate indications, it can be used safely in all malleolus fractures where cannulated screws are used.