Abstract
Excessive displacement or talar shift after an ankle fracture is an indication for open reduction and internal fixation to restore the original length and orientation of the fibula. Surgical fixation is more difficult in cases requiring revision fixation, in cases of nonunion and in cases where the fracture occurs in osteopenic bone. In such circumstances the original AO technique may not confer adequate stability to permit fracture healing. We describe a new technique in which the initial anatomic reduction is first held with a posterior antiglide plate that allows the distal screws to be longer and bi-cortical without risking joint penetration. A second semi-tubular plate on the lateral border of the fibula offers more opportunities for screw placement and enhances torsional stability. In this paper we describe this surgical technique in detail together with case examples of where it can be used.
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