Fixation of Medial Malleolar Fractures .

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].

Inclusion criteria

Patients with Isolted medial malleolar fractures or combined with other fractures [ bimalleolar or trimalleolar Fractures]

Individuals meeting the following criteria will be included in the study:

• Patient Age between 20 _50 Years old.
• Simple or compound fractures (Grade I).
• Recent Fractures .
• Herscovici Type B and C Fractures. a:

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Exclusion criteria

• Skeletally Immature . Compound fractures ( Grade II,III). Pathological fractures. Diabetic patients .