A biomechanical evaluation of multiple fixation methods for the treatment of low transverse distal fibula fractures seen with supination adduction ankle injuries using an osteoporotic sawbones model

This study sought to determine the best biomechanical fixation of low transverse distal fibula fractures as seen in supination-adduction-type ankle fractures. Four different fixation methods-a one-third tubular plate with 1 distal screw, a one-third tubular plate with 2 distal screws, a 2.4-mm mini fragment T-plate, and a fibular-specific locking plate-were compared for fixation of low transverse distal fibula fractures using an osteoporotic Sawbones model. Biomechanical testing was performed to determine stiffness of the constructs as well as load to failure (survival). A one-third tubular plate with either 1 or 2 screws distally as well as a fibula-specific locking plate was biomechanically stiffer than a 2.4-mm mini frag T-plate. Survival rates between groups were not significantly different. These results suggest the use of either a one-third tubular plate or a fibula-specific locking plate for fixation of low transverse distal fibula fractures, especially in osteoporotic bone.