Closed reduction and percutaneous fixation versus open reduction and internal fixation for displaced medial malleolar fractures: a randomized controlled trial.

Study Summary

50 patients with isolated displaced medial malleolar fractures (Herscovici types B and C) were randomized to receive closed reduction and percutaneous fixation (CRPF) or open reduction and internal fixation (ORIF). The primary outcomes of interest were radiological fracture alignment and functional recovery assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score. Secondary outcomes included postoperative complications, associations between comorbidities and complications, age-related radiological outcomes, and the relationship between injury mechanism and functional recovery. Outcomes were assessed at 6 months postoperatively. Overall, the results of the study revealed no significant differences in radiological outcomes, AOFAS scores, or postoperative complications between CRPF and ORIF (p > 0.05). However, diabetes, hypertension, and cardiac disease were significantly associated with increased postoperative complications (p < 0.05). These findings suggested that CRPF may be a viable minimally invasive alternative to ORIF, although equivalence between the techniques was not established.