title: Locked plate fixation of the comminuted distal fibula: a biomechanical study.
abstract: BACKGROUND
  The purpose of this study was to compare the biomechanical properties of locked versus nonlocked lateral fibular bridge plating of comminuted, unstable ankle fractures in a mode of catastrophic failure.
  
  
  METHODS
  We created comminuted Weber C fractures in 8 paired limbs from fresh cadavers. Fractures were plated with either standard or locked one-third tubular bridge plating techniques. Specimens were biomechanically evaluated by external rotation to failure while subjected to a compressive load approximating body weight. We measured the angle to failure, torque to failure, energy to failure and construct stiffness.
  
  
  RESULTS
  There was no significant difference in construct stiffness or other biomechanical properties between locked and standard one-third tubular plating techniques.
  
  
  CONCLUSIONS
  We found no difference in biomechanical properties between locked and standard bridge plating of a comminuted Weber C fibular fracture in a model of catastrophic failure. It is likely that augmentation of fixation with K-wires or transtibial screws provides a construct superior to locked bridge plating alone. Further biomechanical and clinical analysis is required to improve understanding of the role of locked plating in ankle fractures and in osteoporotic bone.
authors.affiliation: Orthopaedic Trauma, the Royal Infirmary of Edinburgh, Scotland, UK. neiljwhite@gmail.com
authors.forename: Neil J
authors.initials: NJ
authors.lastname: White
authors.forename: David T
authors.initials: DT
authors.lastname: Corr
authors.forename: James P
authors.initials: JP
authors.lastname: Wagg
authors.forename: Caeley
authors.initials: C
authors.lastname: Lorincz
authors.forename: Richard E
authors.initials: RE
authors.lastname: Buckley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000150:complications*; D001860:Bone Plates; D004867:Equipment Design; D005260:Female; D005360:Fibula / Q000293:injuries* / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018401:Sample Size