Functional outcome of tension band wiring in transverse fracture of medial malleolus

Abstract

Background and Objectives: Medial malleoli fracture is one of the common fractures in ankle joint mainly due to road traffic accident in which transverse fracture of medial malleolus accounts for significant morbidity and mortality. Tension band wiring (TBW) is an accepted modality of treatment which enables early mobilization of the patients than any other methods of treatment at present. TBW converts a tensile force into compressive force there by improves fracture healing, early mobilization and improved functional outcome of medial malleoli fracture of ankle joint.Materials and Methods: A longitudinal cohort study of transverse fracture of medial malleolus requiring surgical treatment, 20 patients were selected by convenient sampling technique and were operated by tension band wiring technique. In our study we use Lauge- Hansen classification pronation –abduction and pronation- eversion type, patients were evaluated for functional outcome by using American Orthopaedic Foot and Ankle Society (AOFAS) Ankle – Hind foot scale. All data were analyzed using SPSS software v 20.0.Results: The result of our study shows the effectiveness of the procedure for medial malleolus where good to excellent results were obtained in 75% of cases, fair results were in 15% of cases and poor results in 10%.Conclusion: TBW is a simple, inexpensive technique and effective means of fixing medial malleolus fracture based on biomechanical principle with minimum complications. Long term complications of prolonged immobilization like joint stiffness, muscle wasting, pressure sores and osteoporosis are avoided. TBW for medial malleolus helps by achieving compression at fracture site, the fracture heals faster and helps in early rehabilitation.