Bending the plate
Prepare a four hole one-third tubular plate. To improve the anti-glide buttressing effect, the plate is slightly bent at its distal end.
This applies posterior compression on the distal fragment, which augments compression across the fracture plane.
Planning the plate position
Accurate positioning of the plate is essential in obtaining the desired buttress effect and allowing the insertion of a lag screw. The proximal hole closest to the fracture site should be located 3-5 mm proximal to the fracture line. Ensure that the lower end of the plate is not too distal, as, without the integrity of the "ski tip" of the proximal fibular fragment, a too distal point of pressure on the malleolar fragment risks tilting it anteriorly.