Applying the plate after preliminary fixation with a K-wire

If the fracture has been preliminarily fixed with a K-wire, position the plate over the K-wire.

If the wire gets in the way of the plate, it can be advanced to project medially and then cut off flush with the lateral fibular cortex. This way it can be removed medially after the plate has been applied over it.


Screw insertion

Drill a pilot hole through the first plate hole distal to the fracture zone, using a 2.5 mm drill bit and protection sleeve.

Measure the depth with a depth gauge and insert the first cortex screw into the distal fragment.

Next insert the three proximal screws, then complete screw insertion in the distal fragment, remove the K-wire, and  check the syndesmotic stability.