A COMPARATIVE RETROSPECTIVE STUDY: BIOABSORBABLE MAGNESIUM SCREW VERSUS TRADITIONAL TITANIUM SCREW FIXATION IN TREATING MEDIAL MALLEOLAR FRACTURES.

Uday Shankar  Bhagat; Shanu  Saurabh

doi:10.51168/sjhrafrica.v5i3.1053

Authors

Uday Shankar Bhagat Senior Consultant Orthopaedic Surgeon, Department of Orthopaedic Surgeon, J. L. N. M. C. H., Bhagalpur, Bihar, India.
Shanu Saurabh Department of Orthopaedics, Lady Hardinge Medical College, New Delhi, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i3.1053

Keywords:

Medial Malleolar Fractures, Bioabsorbable Magnesium Screws, Titanium Screws, Fracture Fixation, Malunion, Clinical Outcomes

Abstract

Background

The management of medial malleolar fractures has evolved with the emergence of bioabsorbable magnesium screws as an alternative to traditional titanium screws, driven by concerns about hardware removal surgeries due to magnesium's potential for gradual degradation within the body. The study aimed to compare bioabsorbable magnesium screw fixation with traditional titanium screw fixation for treating medial malleolar fractures, assessing outcomes to determine magnesium screws' potential advantages in promoting healing and functional recovery.

Methods

This retrospective study compared bioabsorbable magnesium screw fixation with traditional titanium screw fixation for treating medial malleolar fractures. Eighty patients meeting inclusion criteria underwent operative treatment. Data on demographics, fracture characteristics, radiological assessments, clinical outcomes, and complications were collected and analyzed using statistical methods.

Results

Most of the patients presented with isolated medial malleolar fractures (75%). Fracture union rates were comparable between the two groups, but the magnesium screw fixation group exhibited a substantially lower incidence of malunion (6% vs. 20%, p=0.041) and superior functional outcomes as assessed by the AOFAS Ankle-Hindfoot scale (p=0.019). Although complication rates were lower in the magnesium group, the variation was not statistically relevant. Serial imaging showed progressive degradation of bioabsorbable magnesium screws over time.

Conclusion

Bioabsorbable magnesium screw fixation demonstrated comparable fracture union rates with titanium screws while offering advantages such as lower malunion rates and better functional outcomes. The gradual degradation of magnesium screws suggests potential benefits in reducing the need for hardware removal surgeries and minimizing long-term complications. These findings support the utility of magnesium-based fixation in medial malleolar fractures.

Recommendations

More prospective studies with larger sample sizes and longer follow-up times are recommended to validate findings and investigate screw breakdown rate and bone healing. Comparative biomechanical and long-term investigations of magnesium-based fixation are needed for clinical assessment.