A biomechanical evaluation of locked plating for distal fibula fractures in an osteoporotic sawbone model

Foot Ankle Surg. 2014 Mar;20(1):44-7. doi: 10.1016/j.fas.2013.10.004. Epub 2013 Nov 13.


Background: Supination external rotation (SER) injuries are commonly fixed with a one third tubular neutralization plate. This study investigated if a combination locked plate with additional fixation options was biomechanically superior in osteoporotic bone and comminuted fracture models.

Methods: Using an osteoporotic and a comminuted Sawbones model, SER injuries were fixed with a lag screw for simple oblique fibula fractures, and either a one third tubular neutralization plate or a locking plate. Samples were tested in stiffness, peak torque, displacement at failure, and torsion fatigue.

Results: There was no statistically significant difference in biomechanical testing for fractures treated with a lag screw and plate. For comminuted fractures, locked plating demonstrated statistically significant stiffer fixation.

Conclusion: A combination locked plate is biomechanically superior to a standard one third tubular plate in comminuted SER ankle fractures. There was no biomechanical superiority between locked and one third tubular plates when the fracture was amenable to a lag screw.

Keywords: Ankle fracture; Osteoporotic; Sawbones model; Supination external rotation.

MeSH terms

  • Biomechanical Phenomena
  • Bone Plates
  • Fibula / injuries*
  • Fibula / physiopathology
  • Fibula / surgery*
  • Fracture Fixation, Internal / instrumentation
  • Fractures, Bone / complications
  • Fractures, Bone / physiopathology
  • Fractures, Bone / surgery*
  • Humans
  • Models, Theoretical
  • Osteoporosis / complications*