Comparative analysis between plate and cannulated screw in fracture of the posterior malleolus: a retrospective observational cross-sectional study

Abstract

Introduction: Ankle fractures account for approximately 4% of all fractures, with an annual incidence of 124 in 100,000 people in the United Kingdom. More than a third of these contain involvement of the posterior malleolus. Objective: It was to analyze and compare the anteroposterior screw (PAS) and posterior support plate (PSP) techniques in postoperative results and percentage of complications, comparing radiographic and functional results in the surgical treatment of the posterior malleolus. Methods: The present study followed a retrospective observational and cross-sectional model (STROBE). The Kolmogorov Smirnov test, Student-t test, Wilcoxon Rank test, Mann-Whitney test, Pearson Chi-Square test, and binary and predictive logistic regression analysis were used, adopting a confidence risk of 0.05. Results and Conclusion: A total of 18 patients were included (12 PAS and 6 PSP). For the PAS group, the mean time to fracture healing on radiography was 9.92 weeks, and for the PSP group, it was 11.83 weeks. Using predictive logistic regression analysis, PAS and PSP consolidation times showed a statistically significant difference in data distribution (with p=0.888>0.05), and Haraguchi's classifications for PAS and PSP did not show a statistically significant association, with p>0.05. The two techniques, anteroposterior screw fixation posterior support plate, have advantages and disadvantages inherent to the procedure, as well as the surgeon's aptitude for each technique can be a confusing factor for the study. Little discrepancy was observed in the clinical and radiographic outcomes of the patients analyzed