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Surgical Treatment of a Displaced Lateral Malleolus Fracture: The Antiglide Technique Versus Lateral Plate Fixation

Lamontagne, Jean*; Blachut, Piotr A.; Broekhuyse, Henry M.; O'Brien, Peter J.; Meek, Robert N.

Journal of Orthopaedic Trauma: August 2002 - Volume 16 - Issue 7 - p 498-502
Original Articles

Objectives To assess the outcomes of the surgical management of “isolated” displaced lateral malleolar fractures, comparing the techniques of lateral plating and antiglide plating as described previously.

Design This is a retrospective review, being largely a surgeon-randomized comparative study.

Setting The study was carried out at a university teaching hospital that serves as a provincial trauma referral service and provides local community care. The senior surgeons are all orthopaedic trauma subspecialists.

Patients A total of 193 patients meeting our inclusion criteria, with isolated lateral malleolus fractures surgically treated at the Vancouver General Hospital between 1987 and 1998, were studied.

Intervention Eighty-five were treated with antiglide plating, whereas the remaining 108 patients underwent traditional lateral plating.

Main Outcome Measures The functional results were evaluated with the ankle scoring system described previously. We also compared the complication rates, including failure of fixation, infection, wound dehiscence, and need for hardware removal.

Results Both groups were comparable for age, sex distribution, mechanism of injury, and occupation. There was no difference in ankle score, function, and infection rate. The incidence of wound dehiscence and reoperation for hardware removal was slightly higher in the lateral plate group, but the difference was not statistically significant.

Conclusions The outcome of the surgical management of a displaced lateral malleolus fracture is comparable with both techniques. Although few studies have reported some advantages using the antiglide technique, our data do not support one technique over the other.

*Laval University, Québec, Montréal, Canada, and †Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada

Accepted October 22, 2001.

Address correspondence and reprint requests to Dr. Piotr Blachut, Vancouver General Hospital, University of British Columbia, Department of Orthopaedics, 3rd Floor, Jim Pattison Pavilion–North, 910 West 10th Avenue, Vancouver, British Columbia V5Z 4E3, Canada.

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.

The device that is the subject of this manuscript is FDA approved.

© 2002 Lippincott Williams & Wilkins, Inc.