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Fixation

Prepare plate application

Use a 3 hole one-third tubular plate to buttress this shear fracture.

Position the plate firmly by hand so that two holes lie on the main body of the tibia and one hole on the malleolar fragment. Plan the position of the first proximal screw near the fracture. This screw must be located in the main fragment, 3 mm proximal to the apex of the fracture plane.

Use the 2.5 mm drill bit and protection sleeve. Drill both cortices, but exercise great care not to over-penetrate laterally.