A short single-incision approach for antiglide plate fixation of oblique fractures of the lateral malleolus: a technical tip

Displaced fractures (>2 mm) of the lateral malleolus, without medial or syndesmotic injuries, are often the subject of controversy regarding the best treatment option. In the past, these fractures were usually treated conservatively using a cast for 6 to 8 weeks without weightbearing. Currently, most of the patients desire a quick return to their previous activities, what makes surgical treatment a reasonable choice. It has benefits as earlier ankle mobilization and weightbearing. It also restores ankle biomechanics, preventing secondary osteoarthritis. However, postoperative complications with the standard lateral incision exist such as implant discomfort, dehiscence and infection. Minimally invasive techniques have been described to help avoiding these complications. This technical note described a short single-incision approach for the surgical treatment of displaced oblique fibular fractures type AO/OTA 44-B1 with an antiglide plate that presents the advantage of less risk of damaging the soft tissues, periosteal stripping and disturbance of the fracture hematoma.

Automated summary

Controversy exists over the treatment of displaced lateral malleolar fractures without medial or syndesmotic injuries. While conservative treatment was common in the past, surgical intervention is now preferred by many patients for faster recovery. Surgical treatment offers benefits such as early ankle mobilization and biomechanical restoration, but can also lead to postoperative complications.