{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:16:07Z","timestamp":1789449367991,"version":"build-2803163510"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>Our study aimed to compare the clinical and radiographic outcomes of transitional distal tibia fractures treated with K-wire fixation versus screw fixation after open reduction. A retrospective study was performed on all displaced transitional distal tibia fractures that underwent operative fixation. Following open reduction, surgical fixation was performed using either percutaneously inserted 2.0 mm K-wires, or 4.0 mm partially-threaded cannulated cancellous screws. Clinical and radiographic outcomes between the two groups were assessed using the modified Weber score. Other outcome measures assessed were surgical time, casting duration, follow-up duration and duration before return-to-sports. We recruited 49 patients with transitional distal tibia fractures requiring open reduction and surgical fixation. There were 18 patients in the K-wiring group (KWG), and 31 patients in the screw fixation group (SFG). All patients in both groups had excellent clinical and radiographic outcome based on the modified Weber\u2019s scoring, full radiological healing, and no residual displacement upon final follow up. The KWG had significantly shorter surgical time (41.0\u2009min versus 75.1\u2009min, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001) and shorter follow-up duration needed before discharge (5.4 months versus 8.7 months, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.024). However, they required a longer post-operative casting duration (7.3 weeks versus 5.3 weeks, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.006). No significant difference was found for the duration before return to sports between both groups. Complications were few in this study group. Superficial pin site infection was noted in one patient in the KWG, and valgus deformity of the ankle was noted in one patient in the SFG. In our study, surgical treatment of transitional distal tibia fractures demonstrated equally excellent outcomes when treated by open reduction with either K-wire or cannulated screw fixation. Level of evidence: III.<\/jats:p>","DOI":"10.1097\/bpb.0000000000000830","type":"journal-article","created":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T00:00:07Z","timestamp":1604880007000},"page":"443-449","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Comparison of K-wire versus screw fixation after open reduction of transitional (Tillaux and triplane) distal tibia fractures"],"prefix":"10.1097","volume":"30","author":[{"given":"Neeraj","family":"Mishra","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zackary Kerk Hsiang","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai Yet","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjandas","family":"Mahadev","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,11,6]]},"reference":[{"key":"R1-20250526","doi-asserted-by":"crossref","first-page":"438","DOI":"10.2106\/00004623-198365040-00002","article-title":"Fractures of the distal tibial epiphysis in adolescence.","volume":"65","author":"Dias","year":"1983","journal-title":"J Bone Joint Surg Am"},{"key":"R2-20250526","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.3928\/01477447-20121120-07","article-title":"Review of distal tibial epiphyseal transitional fractures.","volume":"35","author":"Rosenbaum","year":"2012","journal-title":"Orthopedics"},{"key":"R3-20250526","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1097\/BPB.0000000000000522","article-title":"Percutaneous versus open reduction and fixation for Tillaux and triplane fractures: a multicenter cohort comparison study.","volume":"27","author":"Zelenty","year":"2018","journal-title":"J Pediatr Orthop B"},{"key":"R4-20250526","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/BPO.0000000000000085","article-title":"Functional outcome analysis of triplane and Tillaux fractures after closed reduction and percutaneous fixation.","volume":"34","author":"Choudhry","year":"2014","journal-title":"J Pediatr Orthop"},{"key":"R5-20250526","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1097\/01241398-199305000-00022","article-title":"Percutaneous reduction and fixation of displaced juvenile Tillaux fractures: a new surgical technique.","volume":"13","author":"Schlesinger","year":"1993","journal-title":"J Pediatr Orthop"},{"key":"R6-20250526","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.injury.2006.07.033","article-title":"Open reduction and internal fixation in displaced juvenile Tillaux fractures.","volume":"38","author":"Kaya","year":"2007","journal-title":"Injury"},{"key":"R7-20250526","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/00003086-198609000-00032","article-title":"The juvenile fracture of Tillaux.","volume":"210","author":"Stefanich","year":"1986","journal-title":"Clin Orthop Relat Res"},{"key":"R8-20250526","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1177\/230949901302100115","article-title":"Triplane fractures of the distal tibia in children.","volume":"21","author":"Tan","year":"2013","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"R9-20250526","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/s00508-016-1059-9","article-title":"Displaced juvenile Tillaux fractures: surgical treatment and outcome.","volume":"129","author":"Tiefenboeck","year":"2017","journal-title":"Wien Klin Wochenschr"},{"key":"R10-20250526","doi-asserted-by":"crossref","first-page":"34","DOI":"10.4055\/cios.2010.2.1.34","article-title":"Treatment outcomes of triplane and Tillaux fractures of the ankle in adolescence.","volume":"2","author":"Kim","year":"2010","journal-title":"Clin Orthop Surg"},{"key":"R11-20250526","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1097\/BPB.0000000000000506","article-title":"Is an operation always needed for pediatric triplane fractures? 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