Special Technical ArticlesA 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 ModelGao, Ian MD*; Ahearn, Briggs M. MD*; Fantry, Amanda MD†; Tenenbaum, Shay MD‡; Bariteau, Jason MD* Author Information *Department of Orthopaedic Surgery, Emory University, Atlanta, GA †Department of Orthopaedic Surgery, Brown University, Providence, RI ‡Department of Orthopaedic Surgery, Chaim Sheba Medical Center at Tel Hashomer, Tel Aviv University, Ramat Gan, Israel The authors declare that they have nothing to disclose. For reprint requests, or additional information and guidance on the techniques described in the article, please contact Briggs M. Ahearn, MD, at [email protected] or by mail at Emory University Department of Orthopaedic Surgery, 59 Executive Park Dr NE, Atlanta, GA 30329. You may inquire whether the author(s) will agree to phone conferences and/or visits regarding these techniques. Techniques in Orthopaedics: March 2021 - Volume 36 - Issue 1 - p 64-67 doi: 10.1097/BTO.0000000000000378 Buy Metrics Abstract 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. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.