POSTERIOR PLATING OF DISPLACED WEBER-B-FIBULA FRACTURES

This is a prospective study that examines 32 patients who were treated with posterior plating of a displaced Weber B fibula fracture and had a minimum of 1 year follow-up. The surgical technique included applic ation of an unbent one-third tubular plate to the posterior aspect of the fibula using the antiglide technique. Twenty-seven fractures were classified as supination-eversion IV: 13 with deltoid disruption and 1 4 with a medial malleolar fracture. Three were classified as pronation -abduction and two as low pronation-eversion fractures at the level of the plafond. A six-hole plate was used most often (is cases), and 23 patients had a lag screw placed through the plate. There were no nonun ions or malunions. No wound complications, screw loosening, loss of fi xation, intraarticular screws, or palpable screws were found. Four pat ients had transient peroneal tendinitis that resolved in 4-8 weeks. Tw o patients had later plate removal caused by poor technique because of a symptomatic lag screw. Twenty of the 21 patients who returned a que stionnaire were satisfied with their result (95%). Posterior fibular p lating offers many advantages over lateral plating, including the poss ibility of no intraarticular or palpable screws and an improved and st ronger distal fixation construct. Our favorable results suggest that t his technique should be given consideration as a treatment of choice f or displaced Weber B fibula fractures.