Objective: The Ankle fractures are becoming more prevalent as a result of increased road traffic accidents and sports injuries. There are various modalities of treatment available for Medial Malleolus fractures. Undisplaced fractures are managed conservatively with slab or cast and displaced fractures are fixed with screws, k wires, anchors, tension wiring and plates. The main objective of the study is to compare the clinical outcomes of Tension band wiring versus Malleolar screws in managing Displaced Isolated Medial Malleolus fractures.

Methods: This is a cross-sectional study conducted in the Department of Orthopaedics in Kurnool Medical College with 35 patients from November 2022 to November 2023 over one year with displaced isolated Medial Malleolus fractures. Postoperatively the patients are evaluated based on clinical and radiological examinations at one, three, and six months, respectively.

Results: The patients are evaluated with Baird and Jackson scoring system postoperatively, where Excellent score: 8(47%) in group 1 and 7(38.8%) in group 2; Good score: 8(47%) in group 1 and 8(44.4 %) in group 2; Fair score: 1(5.8%) in group 1 and 2(11.1%) in group 2; Poor score: 0 in group 1 and 1(5.5%) in group 2. Hence excellent and good results are obtained in 16(94%) patients in group 1(TBW) and 15(82.2) patients in group 2(Malleolar Screws).

Conclusion: Tension band wiring can be a better option than Malleolar screws in fixation of Displaced Isolated Medial Malleolus fractures.