Indications

  • Displaced, unstable fractures 
  • Osteoporotic bone
  • Open fractures with severe soft-tissue injury 
  • Loss of reduction after nonoperative treatment

Contraindications

  • Tillaux-Chaput or Le Fort / Wagstaff lesion
  • Poor general condition of the patient (high anesthetic risk) 
  • Low demand patient
  • Poor state of soft tissues 
  • Peripheral vascular diseases

Advantages

  • Less dissection (compared to neutralization plate)
  • Indirect reduction through the plate
  • Less skin irritation because of posterolateral plate position
  • Early weight bearing
  • Anatomical reduction of the joint 
  • Early functional recovery 
  • Good long-term functional results

Disadvantages

  • Skin irritation through bulky implant
  • Risk of wound infection 
  • Risk of soft-tissue breakdown
  • Distal positioning of the plate on the distal fragment limited by peroneal tendons 
  • Risk of injury to peroneal tendons