One hundred and fifty-five patients who had a closed, displaced medial
malleolar, bimalleolar, or trimalleolar fracture of the ankle were managed
with medial malleolar fixation with use of either 4.0-millimeter
orientruded polylactide screws (eighty-three patients, study group) or
4.0-millimeter stainless-steel screws (seventy-two patients, control
group). All lateral malleolar fractures were stabilized with standard
metallic implants. At an average of thirty-seven months (range, twenty-one
to fifty-nine months), the radiographic and functional results in the two
groups were equivalent. Differences between the two groups with regard to
the rates of operative and postoperative complications were not
statistically significant. Late spontaneous drainage of the hydrolyzed
polylactide was not noted in any patient in the study group. The prevalence
of late tenderness over the medial malleolar implant was lower in the
patients in whom the fracture had been stabilized with polylactide screws.
We conclude that polylactide screws are a safe and effective alternative to
stainless-steel screws for the fixation of displaced medial malleolar
fractures.