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Journals / Çukurova Anestezi ve Cerrahi Bilimler Dergisi / 2026 / Cilt: 8 Sayı: 1

Comparison of Percutaneous Screw Fixation and Conservative Treatment of Posterior Malleolar Fractures: A Radiological and Functional Outcomes Analysis

Posterior Malleol Kırıklarında Perkütan Vida Fiksasyonu ve Konservatif Tedavinin Karşılaştırılması: Radyolojik ve Fonksiyonel Sonuçların Analizi

Mehmet Maden(Izmir Ataturk Training and Research Hospital)0000-0001-5298-6674
Tayfun Bacaksız(IZMIR KATIP CELEBI UNIVERSITY)0000-0002-8090-4370
İhsan Akan(IZMIR KATIP CELEBI UNIVERSITY)0000-0002-9473-7307
Özgür Doğan Aydin(Izmir City Hospital)0000-0003-0048-7309
Cem Özcan(IZMIR KATIP CELEBI UNIVERSITY)0000-0003-1716-9884
Pages
46–50
Publication Date
2025-03-19
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Further research is needed to explore these findings.

📌 3 Key Takeaways

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Objective & Hypothesis:ABSTRACT Aim: The aim of this study was to compare the clinical and radiological results in patients with trimalleolar fractures with a small posterior malleolar fragment of the ankle joint with and without percutaneous screw fixation.
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Key Findings & Data:Materials and Methods: The study involved patients (18-65 years) with (Group 1) or without (Group 2) percutaneous screw fixation of posterior malleolus fractures between January 2017 and December 2023.
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Conclusion & Impact:Further research is needed to explore these findings.
🔬Design:Klinik Araştırma
📍Scope:2017 Verileri
⚙️Variables:Posterior malleol · Kırık · Vida tespiti

Abstract

ABSTRACT Aim: The aim of this study was to compare the clinical and radiological results in patients with trimalleolar fractures with a small posterior malleolar fragment of the ankle joint with and without percutaneous screw fixation. Materials and Methods: The study involved patients (18-65 years) with (Group 1) or without (Group 2) percutaneous screw fixation of posterior malleolus fractures between January 2017 and December 2023. Clinical and radiological evaluation was conducted at various time points up to the last follow-up. Functional evaluation was conducted using American Orthopaedic Foot and Ankle Scores (AOFAS), Visual Analogue Scores (VAS), and dorsiflexion restriction. Radiological evaluation included the measurement of the gap and step between at the fracture site and presence of ankle osteoarthritis. Results: In this study, sixty-five patients (Group 1: 33, Group 2: 32) who met the inclusion criteria were followed up for a mean of 31.65±6.4 (24–44) months. There were no significant differences in the clinical results between the groups (p > 0.05). At the final radiograph, the mean gap and step distances in Group 1 were lower than in Group 2 (p < 0.001). There was no significant difference between the groups regarding the presence of ankle osteoarthrosis (p = 0.658). Conclusion: This study indicates that while percutaneous screw fixation of small posterior malleolus fragments does not significantly improve clinical outcomes compared to non-fixation, it does result in better radiological alignment. The findings suggest that maintaining joint congruity may be more crucial than fixation in preventing posttraumatic ankle osteoarthritis. Further research is needed to explore these findings.

Özet

Amaç: Bu çalışmanın amacı küçük posterior malleol kırık fragmanı olan trimalleolar kırıklı hastalarda perkütan vida fiksasyonu uygulanan ve uygulanmayan grupların klinik ve radyolojik sonuçlarını karşılaştırılmaktı. Materyal ve Metod: Çalışmaya Ocak 2017-Aralık 2023 tarihleri arasında posterior malleol kırıklarının perkütan vida ile tespit edildiği (Grup 1) ve edilmediği (Grup 2) hastalar (18-65 yaş) dahil edildi. Son takibe kadar çeşitli zaman aralıklarında klinik ve radyolojik değerlendirme yapılmıştır. Fonksiyonel değerlendirme Amerikan Ortopedik Ayak ve Ayak Bileği Skorları (AOFAS), Görsel Analog Skorları (VAS) ve dorsifleksiyon kısıtlılığı kullanılarak gerçekleştirilmiştir. Radyolojik değerlendirme, kırık bölgesinde boşluk ile basamaklanma ölçümü ve ayak bileği osteoartriti varlığını içeriyordu. Bulgular: Bu çalışmada, dahil edilme kriterlerini karşılayan altmış beş hasta (Grup 1: 33, Grup 2: 32) ortalama 31.65±6.4 (24-44) ay takip edildi.Gruplar arasında klinik sonuçlar açısından anlamlı bir fark bulunmamıştır (p > 0.05). Son radyografide, Grup 1'deki ortalama boşluk ve basamaklanma Grup 2'ye göre daha düşüktü (p < 0.001). Ayak bileği osteoartrozu varlığı açısından gruplar arasında anlamlı bir fark yoktu (p = 0.658). Sonuç: Bu çalışma küçük posterior malleol fragmanlarının perkütan vida fiksasyonunun, fiksasyon yapılmamasına kıyasla klinik sonuçları önemli ölçüde iyileştirmediğini, ancak daha iyi radyolojik sonuçlar sağladığını göstermektedir. Bulgular, travma sonrası ayak bileği osteoartritinin önlenmesinde eklem uyumunun korunmasının fiksasyondan daha önemli olabileceğini düşündürmektedir.Bu bulguları incelemek için daha fazla araştırmaya ihtiyaç vardır.

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Cite This Article

Maden, M., Bacaksız, T., Akan, İ., Aydin, Ö. D., Özcan, C. (2025). Comparison of Percutaneous Screw Fixation and Conservative Treatment of Posterior Malleolar Fractures: A Radiological and Functional Outcomes Analysis. Çukurova Anestezi ve Cerrahi Bilimler Dergisi, Cilt: 8 Sayı: 1, 46–50. https://doi.org/10.36516/jocass.1647598

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