This article depicts the percutaneous fixation of medial malleolus fracture. The fracture was vertical type and minimally displaced.
The patient had a history of twisting of ankle and broke medial malleolus. Following is the anterior and posterior x-rays of ankle showing the medial malleolus x-ray.
Being an active adult patient and considering the configuration of the fracture, it was decided that the fracture would be fixed. As the fracture was minimally displaced, an attempt to fix the fracture percutaneously without disturbing the soft tissues was made.
Patient was investigated and preanesthetic evaluation done.
Spinal anesthesia was used and patient was kept in supine position. The limb was externally rotated for better access from medial side.
The fracture was checked in Carm.
The fracture was held in position with a help of K-wire jockey stick.
The hole for first screw was drilled after confirming position in C-arm .
After drilling the hole a malleolar screw was inserted. Here is the peroperative x-ray of screw being inserted.
Similarly, second screw was inserted.
After second screw was inserted, the positions were checked.
The incision sites for screw insertion were stapled.
Immediate postoperative x-ray showed well reduced fracture in both AP and lateral views.
Patient was followed up over a period.
Staples were removed after 12 days.
The fracture showed good union on serial x-rays.
Weight bearing was allowed after 8 weeks of surgery.
Here is an x-ray done after 3 months of surgery.
The fracture is well united and ankle is well reduced.
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