To evaluate the clinical results between the posterior and lateral plate for distal fibular fixation in the bimalleolar, trimalleolar fracture and isolated lateral malleolar fractures with more than 3 mm of displacement.

We reviewed 69 cases treated by open reduction and internal fixation with the posterior or lateral plate for distal fibular fractures in the bimalleolar, trimalleolar fractures and isolated lateral malleolar fractures with more than 3mm of displacement. The follow up period was more than 12 months.

In the posterior plate group, radiographically there were no intraarticular screw, loss of fixation, nonunion and malunion, but 2 cases of distal tibiofibular synostosis were developed. In physical examination, there were no wound complication, palpable screws, peroneal tendinitis and limitation of motion, but 2 patients who had distal tibiofibular synostosis complained of mild discomfort after walking.

The posterior plate for distal fibular fixation is thought to be a favorable method and can be recommended as the fixation modality of choice regardless of level of fracture, because of increased biomechanical stability and few complication.