Indications

  • Oblique fracture of the fibula, transsyndesmotic, with the tip of the proximal fragment additionally fractured "Le Fort fragment"
  • Osteoporotic bone
  • Displaced, unstable fractures
  • Open fractures with severe soft-tissue injury 
  • Loss of reduction after nonoperative treatment

Contraindications

  • Truly multifragmentary fibular fracture
  • Patient not fit for surgery
  • Low demand patient 
  • Peripheral vascular diseases 
  • Poor state of soft tissues

Advantages

  • Buttressing effect against displacement of the distal fragment
  • Less implant prominence because of posterolateral plate position
  • Earlier weight bearing
  • Reconstruction of the joint 
  • Early functional recovery 
  • Good long-term functional results

Disadvantages

  • Distal positioning of the plate on the distal fragment limited by peroneal tendons 
  • Risk of injury to peroneal tendons 
  • Risk of inadequate reduction
  • Risk of wound infection 
  • Risk of soft-tissue breakdown