The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures

The aim of this study was to compare the clinical and radiological results of plate-screw and tension band fixation in isolated Danis-Weber Type A and B lateral malleolar fractures. A total of 135 cases of lateral malleolar fractures (82 Danis-Weber Type B and 53 Type A) operated on in 4 different centers and 6 orthopaedic clinics between November 2005 and December 2010 were reviewed retrospectively. Eigthy-one patients (55 Type B and 26 Type A) had lateral 1/3 tubular plate and screw fixation (Group 1), while the remaining 54 patients (27 Type B and 27 Type A) were operated on with tension band technique (Group 2). The clinical and radiological results of the groups were compared. Student t test was used in statistical analysis. The mean length of surgical incision scar was 4.9 cm (4.5-5.4 cm) for Type A fractures and 6.8 cm (5.6-7.5 cm) for Type B in Group 1 and 4.0 cm (3.5-5.2 cm) for Type A and 5.3 cm (5.0-5.9 cm) for Type B fractures in Group 2. Radiological union was obtained at mean of 10 weeks (7-13 weeks) in Group 1 and 9 weeks (7-12) in Group 2. The implant had to be removed in 12 patients in Group 1 and in one patient in Group 2. The mean AOFAS Score was 90 (72-100) and 92 (70-100) in Groups 1 and 2, respectively. Both plate-screw and tension band techniques revealed excellent results in isolated Danis-Weber Type A and B fractures. The tension band technique may be an alternative fixation method in the treatment of these fractures.