The minimally invasive approach for lateral malleolus fractures plating demonstrating less pain, shorter operative time and earlier discharge compared to open approach: a prospective randomized controlled trial

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dc.contributor.authorKurt, Emre
dc.contributor.authorDemir, Tugcan
dc.contributor.authorTeksan, Emre
dc.contributor.authorKaraca, Halil
dc.contributor.authorAytekin, Kursad
dc.date.accessioned2026-04-25T14:20:18Z
dc.date.available2026-04-25T14:20:18Z
dc.date.issued2026
dc.departmentSinop Üniversitesi
dc.description.abstractBackground Open reduction and internal fixation (ORIF) has been a long-established and accepted technique for the treatment of lateral malleolar fractures. However, minimally invasive percutaneous plate osteosynthesis (MIPPO) may be preferred in cases with compromised soft tissue conditions or in the presence of comorbidities. MIPPO is increasingly being used in the treatment of long bone fractures. The aim of this study was to compare the clinical, functional and radiological outcomes of the MIPPO technique for lateral malleolus fractures with those of ORIF. Methods This prospective randomized controlled study analysed patients who underwent surgery for lateral malleolus fractures treated with ORIF or MIPPO between the years 2022 and 2024. The study included patients with lateral malleolus fractures of Danis-Weber types B and C requiring surgical intervention. Postoperative pain, the American Orthopaedic Foot and Ankle Society (AOFAS) score, hospital stay, surgical time, fluoroscopy time, and radiological measurements were compared. Results The study included 68 patients (ORIF n = 34, MIPPO n = 34). The minimum follow-up for all the patients was 12 months and maximum was 24 months with a mean of 18,20 months postoperatively. The postoperative pain scores at 8 h (p = 0.001), 24 h (p < 0.001) and 2 weeks (p = 0.003) were lower in the MIPPO group. Pain scores were similar between the preoperative measurement and those observed at 4 weeks, 6 weeks, 3 months, 6 months and 1 year postoperatively. AOFAS scores were similar between both groups at 3 months, 6 months and 1 year postoperatively. Surgical time and the postoperative hospitalisation period were shorter in the MIPPO group (p < 0.001, p = 0.005). A higher level of fluoroscopy exposure was observed in the MIPPO group (p = 0.001). Similar results were obtained in radiological measurements between groups. Conclusion The MIPPO technique leads to lower pain scores in the short term, shorter surgery times, and earlier discharge. In the long term, it provides similar clinical, functional, and radiological results to those obtained with ORIF.
dc.identifier.doi10.1186/s13018-025-06624-z
dc.identifier.issn1749-799X
dc.identifier.issue1
dc.identifier.orcid0000-0001-7588-4689
dc.identifier.orcid0000-0002-0273-832X
dc.identifier.pmid41654953
dc.identifier.scopusqualityN/A
dc.identifier.urihttps://doi.org/10.1186/s13018-025-06624-z
dc.identifier.urihttps://hdl.handle.net/11486/8492
dc.identifier.volume21
dc.identifier.wosWOS:001690122500001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherBmc
dc.relation.ispartofJournal of Orthopaedic Surgery and Research
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20260420
dc.subjectLateral malleolus fracture
dc.subjectMinimally invasive surgery
dc.subjectOpen reduction
dc.subjectPostoperative pain
dc.subjectRandomized clinical trial
dc.titleThe minimally invasive approach for lateral malleolus fractures plating demonstrating less pain, shorter operative time and earlier discharge compared to open approach: a prospective randomized controlled trial
dc.typeArticle

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