Biomechanical analysis of polyaxial locking vs. non-locking plate fixation of unstable fractures of the distal fibula: A cadaver study with a bone only model.

BACKGROUND

Open reduction and internal fixation is the current standard of treatment of displaced distal fibula fractures, whereupon using a lag screw often is impossible because of a multifragmantary fracturezone. This study investigates in what extend polyaxial-locking plating is superior to non-locking constructs in unstable distal fibula fractures.

METHODS

Seven pairs of human cadaver fibulae were double osteotomized in standardized fashion with a 5mm gap. This gap simulated an area of comminution, where both main fragments were no longer in direct contact. One fibula of the pair was managed using a 3.5-mm screw in a polyaxial-locking construct and the other fibula in a non-locking construct.