ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1581909
This article is part of the Research TopicDiagnosis and Treatment in Age-related musculoskeletal disordersView all 8 articles
Modified T-plate Internal Fixation in the Treatment of Medial Malleolus Fractures of the Distal Tibia in the Elderly
Provisionally accepted
- Central Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, Hebei Province, China
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Objective: This study aimed to compare the clinical efficacy of modified T-plate internal fixation versus conventional cannulated lag screws in treating medial malleolus fractures of the distal tibia in elderly patients, with a focus on surgical outcomes, functional recovery, and complication profiles.Methods: A prospective cohort analysis was conducted on a sample of 46 elderly patients (aged >= 60 years) with isolated medial malleolus fractures treated at a single orthopedic center between April 2020 and December 2022. Patients were allocated to either modified T-plate internal fixation (n = 23) or cannulated lag screw internal fixation (n = 23). The postoperative conditions, including operative time, blood loss, and complications, as well as the long-term rehabilitation outcomes, such as AOFAS ankle and hindfoot score at 3, 6, and 12 months, were systematically compared. Results: The modified T-plate group exhibited significantly superior early functional recovery, with higher AOFAS ankle and hindfoot score at 3 months (63.5 ± 8.0 vs. 55.3 ± 13.3, P = 0.015) and 6 months (74.6 ± 8.9 vs. 67.8 ± 12.5, P = 0.041), though operative time was longer (85.6 ± 12.3 vs. 72.4 ± 10.8 minutes, P<0.001). No significant differences were observed in intraoperative blood loss (120.5 ± 25.6 vs. 115.8 ± 22.4 mL, P = 0.511), overall complication rates (8.7% vs. 17.4%, P = 0.381), or long-term outcomes of AOFAS ankle and hindfoot score at 12 month (89.0 ± 8.7 vs. 87.9 ± 7.6, P = 0.628). Both groups demonstrated comparable safety profiles, with no severe complications during a mean 14.4-month follow-up.Conclusion: Modified T-plate fixation has been shown to facilitate early functional rehabilitation in elderly patients with distal tibial medial malleolus fractures. Although this method requires marginally longer operative time, it offers equivalent long-term outcomes and safety to traditional lag screws internal fixation. Notably, it is particularly advantageous for osteoporotic patients, as it addresses the challenges posed by bone fragility and compromised healing capacity.
Keywords: Tibia fracture, modified T-plate, Internal fixation surgery, Long-term rehabilitation, cannulated lag screws
Received: 23 Feb 2025; Accepted: 27 May 2025.
Copyright: © 2025 Wang, Nie, Liu and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Cong Jiang, Central Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, 430014, Hebei Province, China
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