الفهرس 
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Abstract
The pattern of injury to the ankle joint depends on many factors including the age of the patient, the quality of the bone, the position of the foot at the time of injury, and the direction, magnitude, and the rate of the loading forces.
Nondisplaced fractures of the medial malleolus usually can be treated with cast immobilization; however, in individuals with high functional demands, internal fixation may be appropriate to hasten healing and rehabilitation. Displaced fractures of the medial malleolus should be treated surgically because persistent displacement allows the talus to tilt into varus.
Since open reduction and internal fixation by cancellous screws or tension band wiring is the traditional method of management of medial malleolar fractures, percutaneous fixation of medial malleolus fractures makes minimally invasive surgical trauma, less bleeding (almost zero).
The aim of this work was to evaluate the results of closed percutaneous fixation of isolated medial malleolar fractures in adult using cancellous screws.
This prospective study included 20 patients. It included 16 male (80%) and 4 females (20%), and the mean age was 30.2 years old ranging from 18 years to 45 years. There was 7 cases (35%) type B, and 12 cases (60%) type C, and one case (5%) type D according to Herscovici classification.
from the studied cases there was16 patient (80%) have no displacement after fixation of fracture, 3 patient (15%) have 1mm. distal displacement at the fracture site and 1 patients (5% )have 2mm. distal displacement.
At the end of follow up 14 patients (70) had a united fracture after 6 weeks and 6 patients after 8 weeks. One patient (5%) had a superficial infection at the site of incision, 19 patients (95%) had no infection and no one had a deep infection, malunion, nonunion, wound sloughing, ankle arthrosis.
The subjective clinical results of the study showed that two patients
(10%) were fair and the other 18 patients (90%) were good and the mean Joy’s subjective clinical score was 3.55. The objective clinical score showed that one patient (5%) is fair and the other 19 patients (95%) are good and the mean Joy’s objective clinical score was 3.6. All patients had good radiological score according to Joy’s radiological score.
The final clinical results were affected by type of the fracture and postoperative displacement but not affected by age or sex.