Ankle Frx: Plate Position and Application


- See: Antiglide Plate

- Discussion:
    - position of plate is dependent on level of frx, condition of overlying soft tissues, and the extent of comminution;

- Posteriorly Positioned Plate:
    - see antiglide plate:
    - allows use of a thicker, stronger plate;
    - less risk of wound slough;
    - irritate peroneal tendons;
    - distal screws obtain better purchase, since they engage a thicker part of distal fibula, and engage 2 cortices without risk of joint penetration;
    - posterior plate will not allow a syndesmotic screw to pass thru 1/3 tubular plate;

- Laterally Positioned Plate:
    - 1/3 tubular plate conforms to the curvature of the fibula and has a lower profile than the thicker compresssion plates;
    - Plate Contouring:
            - distal fibula also has a lateral bow, which should be restored as part of an anatomic reduction;
            - plate must be contoured to accommaodate this bow to prevent medial displacement of frx or excessive compression of Mortise;
    - plate is fixed w/ 3.5 mm cortical screws;
    - it is usually possible to place 2 or 3 screws distal to frx and 3 screws proximal to the fracture;
    - distal screws should engage the medial cortex of the fibula but not protrude into the fibulotalar joint



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, November 27, 2012 1:41 pm