Modified One-third Tubular Plate with Hook for Distal Lateral Malleolus Fracture Fixation

Fracture of the lateral malleolus is a commonly encountered problem in the orthopaedic fraternity1 . Among the lateral malleolus fractures, Weber type B is the most common injury, accounting for 60% of all ankle fractures2 . Anatomical reduction and fixation of the distal lateral malleolus fractures are crucial to improve the outcomes in patients1 . They are normally done with a one-third tubular plate with or without an inter-fragmentary lag screw. One-third tubular plate is a suitable implant as there is limited soft tissue coverage overlying the lateral malleolus. A commonly encountered problem intra-operatively is limited space for distal screw placement 3 . Placement of only one distal screw is insufficient to ensure rotational stability, especially in osteoporotic bone3 . Locking plate has been proposed to treat these fractures, but a significant increase in wound complications associated with locking compression plate discourage the use of these implants.