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Ankle Frx: Plate Position and Application

(See also: 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