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Principles

The one-third tubular plate, which is placed posterolaterally on the fibula in an antiglide position, indirectly reduces the fracture and acts as a buttress to resist the posterior and proximal displacement of the distal fragment.

Additionally, the main fracture can be compressed with a lag screw, inserted through the plate.

The third fragment, if large enough, can be fixed to the main lateral malleolar fragment with a cancellous lag screw. This technique is used for the three-part type of transsyndesmotic multifragmentary fracture, in which an oblique fracture of the fibula has occurred through the transsyndesmotic zone, and the tip of the proximal fragment ("ski tip") has fractured off.