Clinical Comparison of Minifragment Plates Versus Conventional Semitubular Plates for Fixation of Distal Fibula Fractures.

BACKGROUND: Although operative stabilization of unstable distal fibula fractures is frequently performed and discussed, the ideal implant and technique for these injuries is still debated. QUESTIONS/PURPOSES: The purpose of this study was to determine if minifragment plating of distal fibula fractures would clinically provide equivalent fixation and cost and minimize hardware prominence when compared with standard one-third tubular plating. PATIENTS AND METHODS: A retrospective review was conducted on 44 patients who had undergone operative stabilization of a displaced fibula fracture. Inclusion required fibula fixation with either a traditional one-third semitubular plate or a 2.7-mm minifragment plate. Retrospective review of the patient demographics, injury and surgical variables, and radiographs was completed by two surgeons not involved with the patients' original care.
RESULTS: The minifragment group demonstrated equivalency in maintenance of fracture reduction relative to standard tubular plating. Both groups were able to maintain the talocrural angle with less than 1° of change from initial postoperative to final postoperative radiographs. No significant differences were seen in postoperative hardware irritation between groups.
CONCLUSIONS: Use of a minifragment plating system for displaced fibula fractures appears to be safe but comes with the significant potential added cost of the technology. Interestingly, no significant differences were seen in implant-related irritation or implant removal, but further investigation with a larger study population would help better determine these outcomes.