(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