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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.


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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.