Osteosynthesis of Weber B Lateral Malleolus Fractures: Minimal Invasive Versus Conventional Plating in Adult Patients

Background: Ankle fractures are among the most common fractures in the lower extremities; Open reduction internal fixation (ORIF) has become the accepted treatment method. Minimally invasive plate osteosynthesis (MIPO) and intramedullary (IM) fixation are less invasive methods. Objectives: to compare the clinical outcome and complications between MIPO technique and conventional plating of Weber B lateral malleolus fractures in adult patients. Patients &Methods: This comparative study was conducted in Orthopedic Surgery Department, Helwan University Hospitals for one year. 30 patients with Lateral malleolus fractures Weber B were divided into ORIF group and MIPO group. All patients were assessed postoperatively using visual analog scale (VAS) for pain (0-10), range of movement of ankle, radiological union, and restoration of radiological anatomy. Complications were assessed. Results: MIPO led to a quicker union time, a reduced rate of overall complications, and lower VAS pain scores during the early postoperative phase and follow-up visits. The MIPO group operated for a longer period of time than the ORIF group, which inevitably resulted in a longer irradiation time under fluoroscopy. Operative time is expected to decrease when experience and learning curve increase. Conclusion: As compared to ORIF, MIPO resulted in a lower rate of overall complications, lower VAS pain scores during the early postoperative period and follow-up visits, and a faster union time.