Bridge plating uses the plate as an extramedullary splint, fixed to the two main fragments, while the fracture zone is left virtually untouched.
Reduction of the distal tibiofibular joint is important Therefore, restoration of the length, axis and rotation of the fibula is crucial. and must be checked intraoperatively under image intensification.
Reduction can usually be achieved indirectly by distraction. Anatomical reduction in the fibular fracture zone is not necessary.
Bridging plates are commonly used in multifragmentary lateral fractures.
Mechanical stability, provided by the bridging plate, should be adequate for indirect healing (callus formation).
In cases of large zones of comminution, stronger plates, such as reconstruction plates or locking compression plates (LCP), provide better stability than one-third-tubular plates.
The angular stability provided by the LCP may be advantageous.
Mechanical stability (syndesmosis)
In suprasyndesmotic fractures (Lauge-Hansen type PE 4), the syndesmosis complex is usually unstable.