Three internal fixation methods for Danis-Weber-B distal fibular fractures: A biomechanical comparison in an osteoporotic fibula model

A common agreement for the surgical treatment of osteoporotic ankle fractures has not been defined yet although locking plates are preferred for fractures with poor bone quality. This study aims to evaluate the mechanical stability of locked and conventional plates on osteoporotic Danis-Weber-B-fibula fracture models. Fractured custom-made osteoporotic fibulae were treated with neutralization plate plus lag screw, locking plate plus lag screw, or a standalone locking plate. Load until failure was applied mimicking single -leg stance. Stiffness, failureload, and interfragmentary movements were investigated. Stiffness, failureload and axial fragment movement showed no significant differences among groups. Shear movements and fragment rotation around the shaft of the neutralization plate were on average twice as high as those of the locking plates. Although no superiority was shown for overall mechanical performance, the locking plate groups exhibited higher shear and rotational stability than the neutralization plate. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of European Foot and Ankle Society. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Automated summary

A common agreement for the surgical treatment of osteoporotic ankle fractures has not been defined yet. This study evaluated the mechanical stability of locked and conventional plates on osteoporotic Danis-Weber-B-fibula fracture models. The results showed that although no overall mechanical superiority was found, the locking plate groups exhibited higher shear and rotational stability compared to the neutralization plate group.