The present study has been approved by ethical committee in our hospital. The informed consent was obtained from all the patients to participate in the study at the latest followup. In this retrospective study, we present the clinical and radiological results in managing comminuted fractures of the lateral malleolus (Weber A, B) with a lateral malleolus hook plate (Königsee Implant Company, Thuringen, Germany). As an alternative fixation, a lateral malleolus hook plate has been used in managing the lateral malleolar fractures. 7, 11, 12 Generally, complex distal lateral malleolar fractures are difficult to fix by conventional internal fixations, especially for comminuted fractures. 7 It is well-accepted that poor fragment stabilization may result in postoperative displacement with a high risk of nonunion or malunion leading to osteoarthritis. 9, 15 A one-third tubular plate is also associated with many complications such as fragment nonunion and dislocation for such cases. 6, 7, 10, 12, 13, 14 However, in cases with small distal fragments, the fixations of the distal fragments by screws or other conventional fixations are challenging. 12 Many studies show that a good reduction and bone union could be achieved for for displaced unstable fractures by ORIF. 1 The lateral malleolar fracture, which exhibits an oblique or spiral pattern is generally stabilized with an infragmentary screw and is supplemented by a neutralizing tubular plate. 1, 11 However, when there is distal fibular fracture with shortening, comminution and rotation, involving the talus instability open reduction and internal fixation (ORIF) is recommended. There are no operative indications for the majority of Weber A and partial Weber B fracture due to good stability. 1, 2, 3 Different techniques are commonly used to address this comminuted fracture, such as K-wires, tension band wires, one-third tubular plate, screws and intramedullary nails. The goal of managing the comminuted fracture of lateral malleolus is to restore length, rotation and alignment which might be more challenging with extensive comminution around the area of the distal tip.
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