Evolution of Technology

Anatomic Distal Fibula Plate

There are a few different options when deciding how to operatively manage a lateral malleolar fracture. The modality most commonly utilized by orthopaedic surgeons is applying an anatomic distal fibula plate. These plates are often contoured to match the native anatomy of the distal fibula.

After reducing the fracture in the operating room, a single plate is applied to the outer surface of the fibula bone and fixed to the bone using screws. This plate helps maintain anatomic reduction of the fracture to allow the body to heal the bone over time. Although seldom, some patients may experience some irritation from these plates over time necessitating their removal down the road.

Evolution of Procedure

Open Reduction Internal Fixation of Distal Fibula

A single plate with multiple screws are commonly utilized for lateral malleolar fractures. Some of the basic principles of fracture fixation are as follows:

  • fractures should be reduced to restore anatomic alignments
  • fractures should be treated with a fixation method that provides stability
  • there must be enough blood supply to allow for the body to heal the injury
  • treatment should allow for early and safe mobilization of the injured area

Ankle fractures usually require additional intraoperative tests to determine ankle stability. If deemed unstable, additional screws or the use of a tightrope construct may be required to obtain ankle stability. Patients should discuss this possibility with their surgeon and how it may affect recovery.

Evolution of Diagnosis

Distal Fibula Fracture

The fibula is the smaller of the two bones between the knee and ankle. It is lateral to the larger “shin” bone, also known as the tibia. The lateral malleolus is the distal most aspect of the fibula and can be felt as the bony prominence at the outside of the ankle. Fractures of the distal fibula (lateral malleolus) occur as a result of a twisting injury to the ankle.

Lateral malleolar fractures as the most common ankle fracture and can often be treated without surgery with application of a splint or a cast following closed reduction. Some operative indications include multiple ankle bones fractured, an open fracture with exposed bone, or instability as determined by radiographic imaging.