Closed reduction and percutaneous fixation versus open reduction and internal fixation for displaced medial malleolar fractures: a randomized controlled trial.
Ahmed Elkohail, Abdulaziz Elkasaby, Ahmed Mohamed Zakaria Shaheen et al.
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In 30 seconds
This randomized controlled trial compared closed reduction and percutaneous fixation (CRPF) to open reduction and internal fixation (ORIF) in 50 adults with isolated displaced medial malleolar fractures. At 6 months, both techniques showed similar radiographic and functional outcomes, with no significant differences in AOFAS scores or complication rates.
Key findings
- AOFAS scores at 6 months showed no significant difference between CRPF and ORIF (p > 0.05).
- Complication rates were similar: wound infection 4% for CRPF vs. 12% for ORIF.
- Diabetes and hypertension were significantly associated with increased sequelae risk (p < 0.05).
Why it matters
Understanding the effectiveness and safety of CRPF versus ORIF for medial malleolar fractures can guide treatment decisions, particularly in optimizing patient outcomes and minimizing complications.
What to keep in mind
No formal sample size calculation or equivalence margin was prespecified, limiting the interpretation of statistical equivalence.