Screw and absorbable suture tension band technique for geriatric weber type A lateral malleolus fractures

Abstract

Purpose

The optimal method of internal fixation for ankle fractures in geriatric patients remains debated. This study aims to assess the efficacy of the screw and absorbable suture self-compression tension band technique in treating Weber Type A lateral malleolus fractures in geriatric patients.

Methods

Clinical data were analyzed from 31 geriatric patients with Weber Type A lateral malleolus fractures treated between March 2018 and June 2022. All patients underwent fixation with two screws combined with an absorbable suture self-compression tension band. The cohort comprised 18 males and 13 females, with a mean age of 65.6 ± 7.3 years. The study recorded operative time, intraoperative blood loss, fracture healing time, and postoperative complications. Outcomes were evaluated using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) for pain, and ankle range of motion (ROM).

Results

Of the 31 patients, 30 achieved primary wound healing. Follow-up periods ranged from 12 to 36 months (mean: 19.5 months). The average operative time was 44.7 ± 13.6 min, with slightly longer times for patients with additional injuries. Fracture healing time ranged from 8 to 16 weeks (mean: 12.1 weeks), with no cases of delayed healing or non-union, and no instances of fixation loosening or failure. Postoperative complications included one cases of superficial infection, one case of numbness, one case of foreign body sensation, and one case of prolonged pain. At the final follow-up, the mean AOFAS score was 89.8 ± 6.2, with VAS scores of 0 in 18 cases, 1 in 11 cases, and 2 in 2 cases. The average ROM was 65.4° ± 4.3°, resulting in a clinical satisfaction rate of 87.1 %.

Conclusion

The use of screws combined with an absorbable suture self-compression tension band for treating Weber Type A lateral malleolus fractures in geriatric patients is straightforward, effective, and warrants broader adoption.