A one-third tubular plate molded as a hook plate can be used to fix a small lateral fragment (where there is space for only one screw), or a severely osteoporotic bone.
The sequence of the application of the hook plate differs from the procedure described above.
First, place the tip of the hook through the ligament into the tip of the lateral malleolus.
Use an impactor for anchoring the hook tip in the bone.
Insert a screw into the hole immediately above the hook to secure the plate onto the distal fragment.
Insert a proximal cortical screw in an eccentric position to obtain compression.
Complete the fixation by inserting the other screws in the planned sequence.