Journal of Musculoskeletal Trauma

Posterior Plating in Distal Fibular Fracture: Choong Hyeok Choi, Young A Cho, Jae Hoon Kim, Il Hoon Sung; J Korean Fract Soc 2007;20(2):161-165. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.161

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 95.5Â±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.

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A Specialized Fibular Locking Plate for Lateral Malleolar Fractures
Eui Dong Yeo, Hak Jun Kim, Woo In Cho, Young Koo Lee
The Journal of Foot and Ankle Surgery.2015; 54(6): 1067. CrossRef

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Radiological Assessment for Distal Fibular Length: Il Hoon Sung, Jong Min Lee; J Korean Soc Fract 2003;16(2):208-214. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.208

Abstract PDF: PURPOSE
This study was performed to reevaluate the radiological parameters for assessing the length of the distal fibula in the mortise view of the ankle and to introduce a more reliable method to lessen measurement error.
MATERIALS AND METHODS
Mortise view radiographs of 36 normal ankles from 18 healthy volunteers were obtained. The talocrural angle and bimalleolar angle were measured two times and compared bilaterally by two independent observers. Also, The lateral malleolar angle, newly devised in our department was measured and compared bilaterally.
RESULTS
The average of the talocrural angle, bimalleolar angle, and lateral malleolar angle was 78.4 degrees (range 74 to 83), 78.3 degrees (range 73 to 86), and 36.7 degrees (range 30 to 41), respectively. The difference of the talocrural angle, bimalleolar angle, and lateral malleolar angle between right and left was 2.1 degrees, 3.0 degrees, and 1.2 degrees (95% confidence limit), respectively. Intraobsever difference of the talocrural angle, bimalleolar angle, and lateral malleolar angle was 1.5 degrees, 1.6 degrees, and 0.4 degrees, respectively. Interobsever difference of the talocrural angle, bimalleolar angle, and lateral malleolar angle was 1.3 degrees, 2.4 degrees, and 1.0 degrees, respectively.
CONCLUSION
When using various measurement methods to judge the length of the distal fibula, the measurement error should be considered. The proposed method, lateral malleolar angle, would be a good method for assessing the length of distal fibula in the mortise view of ankle.

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The Posterior Plate for Distal Fibular Fixation: Beak Yong Song, Ho Yoon Kwak, Sang Wook Bae, Kyung Tai Lee, Nam Hong Choi, Jin Young Kim, Ho Jun Kim; J Korean Soc Fract 2001;14(1):79-84. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.79

Abstract PDF: PURPOSE
To evaluate the clinical results between the posterior and lateral plate for distal fibular fixation in the bimalleolar, trimalleolar fracture and isolated lateral malleolar fractures with more than 3 mm of displacement.
MATERIALS AND METHODS
We reviewed 69 cases treated by open reduction and internal fixation with the posterior or lateral plate for distal fibular fractures in the bimalleolar, trimalleolar fractures and isolated lateral malleolar fractures with more than 3mm of displacement. The follow up period was more than 12 months.
RESULTS
In the posterior plate group, radiographically there were no intraarticular screw, loss of fixation, nonunion and malunion, but 2 cases of distal tibiofibular synostosis were developed. In physical examination, there were no wound complication, palpable screws, peroneal tendinitis and limitation of motion, but 2 patients who had distal tibiofibular synostosis complained of mild discomfort after walking.
CONCLUSION
The posterior plate for distal fibular fixation is thought to be a favorable method and can be recommended as the fixation modality of choice regardless of level of fracture, because of increased biomechanical stability and few complication.

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The Treatment of Danis-Weber Type B Fractures of the Distal Fibula by Multiple Kirschner Wires Fixation: Ho Yoon Kwak, Baik Young Song, Sang Wook Bae, Nam Hong Choi, Jin Young Kim; J Korean Soc Fract 2000;13(3):529-536. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.529

Abstract PDF

PURPOSE
To evaluate the accuracy of reduction and stability of fixation according to different methods of internal fixation for the Danis-Weber classification type B fractures of the distal fibula. MATERIAL AND METHODS: Seventy-three cases with follow up of average 13 months were divided into three groups: plate fixation(Group I, 36), more than two lag screws fixation (Group II, 13) and multiple K wires fixation with less than one lag screw(Group III, 24). We measured the bimalleolar angle and axial displacement of the fracture ends for radiographic evaluation, and used the Meyer's classification for clinical evaluation.
RESULTS
There was significant difference of postoperative fibular shortening between group I(0.44mm) and III(0.17mm) on the anteroposterior view(p=0.003), but no difference of it on the lateral view. The changes of bimalleolar angle and the increment of fibular shortening showed no significant difference among three groups.
CONCLUSION
Multiple K wires fixation combined with less than one lag screw for Danis-Weber type B fractures of distal fibula demonstrated that it provides accurate reduction and stable internal fixation.

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Posterior Plating in Distal Fibular Fracture
Choong-Hyeok Choi, Young-A Cho, Jae-Hoon Kim, Il-Hoon Sung
Journal of the Korean Fracture Society.2007; 20(2): 161. CrossRef

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