• J Foot Ankle Surg · Jan 2007

    Comparative Study

    Fixation of osteoporotic distal fibula fractures: A biomechanical comparison of locking versus conventional plates.

    • Todd Kim, Ugur M Ayturk, Andrew Haskell, Theodore Miclau, and Christian M Puttlitz.
    • Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, USA.
    • J Foot Ankle Surg. 2007 Jan 1; 46 (1): 2-6.

    AbstractThe increased use of locking plates to treat difficult fracture scenarios has been advocated in patients that have reduced bone mineral density. One of these difficult fracture patterns, fixation of the distal fragment of a distal fibula fracture, may depend on unicortical and cancellous bony purchase. This study investigated the construct stiffness afforded by using locking and conventional plating schema in a cadaveric model. Overall, the data indicate that a locking plate construct with two distal unicortical screws was mechanically equivalent to standard plating with 3 distal screws. In addition, fixation with the standard plates was dependent on bone mineral density (BMD) whereas the locking plate fixation was independent of BMD. The clinical implication of this study is that locking plates may be advantageous in patients with the most severe osteoporosis.

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