Posterior Plating in Distal Fibular Fracture

Choong-Hyeok Choi; Young-A Cho; Jae-Hoon Kim; Il-Hoon Sung

doi:10.12671/jkfs.2007.20.2.161

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Choi, Cho, Kim, and Sung: Posterior Plating in Distal Fibular Fracture

Original Article

Journal of the Korean Fracture Society 2007; 20(2): 161-165.

Published online: 14 June 2016

DOI: https://doi.org/10.12671/jkfs.2007.20.2.161

Posterior Plating in Distal Fibular Fracture

Choong-Hyeok Choi, M.D., Young-A Cho, M.D., Jae-Hoon Kim, M.D., Il-Hoon Sung, M.D.

Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, Korea.

Address reprint requests to: Il-Hoon Sung, M.D. Department of Orthopedic Surgery, Hanyang University Hospital, 17, Haengdang-dong, Seongdong-gu, Seoul 133-792, Korea. Tel: 82-2-2290-8485, Fax: 82-2-2299-3774, sungih@hanyang.ac.kr

Abstract

Purpose

To report the technical experience of posterior plating for the distal fibular fracture.

Materials and Methods

20 Weber type-B fibular fractures were included in this study, which were treated with the posterior plating. 1/3 semitubular plate was used and orientation of all screws were intended to be perpendicular to the plate as possible. Fixation stability and maintenance of reduction after plating was assessed manually in the operating field. Clinical results were evaluated at least 1 year after operation, using American Orthopaedic Foot and Ankle Society (AFOAS) Ankle-Hindfoot score.

Results

5 cases were firmly stabilized without using any lag screw or fixation of distal fragment. For improving stability or achieving proper reduction, a lag screw was placed posteroanteriorly through the plate in 14 cases. Anteroposterior interfragmentary fixation in 1 case before plating, and contouring of the plate in 3 cases were needed in cases of which the posterior plating impeded reduction of distal fibular fracture. In all cases, fracture was stabilized without fixation through the most distal hole. There were no major postoperative complications. AFOAS score was 95.5±5.2.

Conclusion

The posterior plating technique for distal fibular fracture is regarded as a recommendable option. Additional fixation with interfragmentary screw or contouring of the plate, however, would be needed in some cases to achieve anatomical reduction or sufficient stability.

Keywords: Distal fibular fracture, Posterior plate

Figures and Tables

Fig. 1

A case, showing bimalleolar fracture of which distal fibula was fixed, using posterior plate without lag screw or fixation of distal fragment.

(A) Preoperative anteroposterior radiography of ankle fracture.

(B, C) Standing anteroposterior and lateral radiography of ankle, 6 months after operation.

Fig. 2

A case, showing bimalleolar fracture of which distal fibula was fixed, using posterior plate with a posteroanterior lag screw.

(A) Preoperative anteroposterior radiography of ankle fracture.

(B, C) Standing anteroposterior and lateral radiography of ankle, 6 months after operation.

Fig. 3

A case, showing bimalleolar equivalent fracture of which distal fibula was fixed, using manually contoured posterior plate with a posteroanterior lag screw.

(A) Preoperative anteroposterior radiography of ankle fracture.

(B, C) Standing anteroposterior and lateral radiography of ankle, 6 months after operation.

Table 1

Clinical data of patients

^*AOFAS score: American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score, ^†PA: Posteroanterior, ^‡AP: Anteroposterior.

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