Fixation of Medial Malleolar Fractures .

The aim of this study is to evaluate the functional and radiological outcomes following of fixation of Herscovici type B and type C medial malleolar fractures with anterograde headless screws.

Ankle fracture is one of the most common orthopaedic injuries\[1\]. Medial Malleolus fractures are Classified According to Herscovici classification Using the anteroposterior (AP) radiograph, he described type A fractures as avulsions of the tip of the malleolus, type B occurring between the tip and the level of the tibial plafond, type C at the level of the plafond, and type D extending vertically above the plafond \[2\]. The aim of operative treatment in ankle fractures is to provide stable internal fixation and allow early movement . Several fixation techniques had been described for the anatomic reduction of fractures, including Kirschner wires (K-wire), tension band method, fixation with suture anchors, bioabsorbable screw fixation, a FiberWire loop with a tension band, and screw fixation\[3\]. In addition to these techniques, fixation with anterograde screws can also be used for medial malleolar fixation. Given that with time the size of the fractured distal fragment in a medial malleolar fracture is insufficient for retrograde fixation as ln Herscovici type B and type C\[4\]. Screws are commonly used to fix medial malleolus fractures , offering advantages like good compression and stability\[5\]. the advantage of the anterograde headless screw fixation technique over the other techniques is that less dissection of the deltoid ligament is required during fixation , no need for screws removal , less soft tissue irritation and less discomfort \[6\].