Comparative Study of Ankle Fracture in Danis Weber Type-C Treated by Small Dynamic Compression Plate Vs 1/3rd Tubular Plate for Lateral Malleolus and 04 mm Cancellous Screw for Medial Malleolus
Keywords:
Danis-Weber type-C; ankle fracture; small dynamic compression plate; one-third tubular plate; AOFAS scoreAbstract
Introduction: Danis-Weber type-C ankle fractures challenge orthopaedic surgeons because of their instability, involving syndesmotic disruption and medial-sided injury. Open reduction and internal fixation (ORIF) are the standard treatment; however, the optimal implant choice between a small dynamic compression plate (DCP) and a one-third tubular plate remains debatable. This study compared the outcomes of Danis-Weber type-C ankle fractures treated with a small DCP versus a one-third tubular plate for the lateral malleolus with a 4 mm cancellous screw for the medial malleolus.
Methods: A quasi-experimental study was conducted at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Bangladesh, from March 2018 to April 2020 and from April 2023 to September 2023. Forty-eight patients with closed Danis-Weber type C ankle fractures were divided into two groups: small dynamic compression plate (DCP) and one-third tubular plate. Functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale at 24 weeks.
Results: The mean age was 35.67 ± 10.5 years, with a male predominance (77%). Road accidents caused the majority of injuries (58%). Radiological union occurred at 15.20 ± 1.19 weeks in the DCP group and 14.62 ± 1.11 weeks in the tubular plate group (p = 0.99). The complication rate was 16% in the DCP group versus 12% in the tubular plate group (p = 0.99). Excellent or good AOFAS outcomes reached 83.33% in DCP and 91.67% of patients treated with DCP and tubular plates, respectively. No significant intergroup differences were observed (all p > 0.05).
Conclusion: No significant difference exists between small DCP and one-third tubular plate fixation for Danis-Weber type-C ankle fractures, although the tubular plate showed modest trends toward better outcomes and fewer complications.
Journal of Surgical Sciences 2025;29(1): 30-36
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