This article depicts the percutaneous fixation of medial malleolus fracture. The fracture was the 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.
The patient was investigated and preanesthetic evaluation done.
Spinal anesthesia was used and the patient was kept in a supine position. The limb was externally rotated for better access from the 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 the first screw was drilled after confirming the position in C-arm .
After drilling the hole a malleolar screw was inserted. Here is the preoperative x-ray of the screw being inserted.
Similarly, the second screw was inserted.
After the second screw was inserted, the positions were checked.
The incision sites for screw insertion were stapled.
Immediate postoperative x-ray showed a well-reduced fracture in both AP and lateral views.
The 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.