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Aim: Modern trend in the management of fractures is fast changing in favor of rigid fixation and early mobilization with minimal period of plaster immobilization. We present a prospective cohort study of fixation of medial malleolus fractures with Minifragment T-plate and its evaluation in terms of maintenance of accurate anatomical reduction, stable fixation, and early restoration of functions. Materials and methods: A total of 25 patients of median age 45 years (22–70), with medial malleolus fractures were treated by open reduction and internal fixation using Minifragment T-plate. Outcome was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score. Results: A total of 80% cases had anatomical reduction, 12% had good reduction (<2 mm displacement), 4% had fair reduction (2–5 mm displacement), and 4% had poor reduction (>5 mm displacement). After 6 months follow-up, outcome was excellent in 20 cases (80%), 3 cases (12%) had good result, and 2 cases (8%) had fair result according to AOFAS score. Out of 25 cases, in 2 cases (8%) infection occurred, 6 cases (24%) had limitation of movements, 1 case (4%) had instability at ankle, and 2 cases (8%) had delayed union of fracture. Conclusion: Weighing the advantages and disadvantages of fixation with Minifragment T-plate, it can be safely concluded that Minifragment T-plate can be an effective alternative option in the management of medial malleolus fractures. At the same time, it is warned that this technique should not be used indiscriminately without technical skill. Clinical significance: Minifragment T-plate fixation provides rigid fixation along with early return of movements with limited period of immobilization. Studying this alternative method expands the present knowledge for management of medial malleolus fractures. JFAS (AP)

Minifragment T-plate Fixation: An Alternative Method for Medial Malleolus Fracture Fixation