Comparison of Posterior and Lateral Surface Plating for Type B Weber Lateral Malleoli Fractures.

Abstract

Purpose: The purpose of this study is to compare the functional outcomes, radiological outcomes, complication rates, and hardware removal between lateral and posterior surface plating in isolated type B Weber lateral malleolus fractures.

Methods: It was a retrospective study that compared the outcomes of type B Weber lateral malleoli fractures treated by either lateral surface or posterior surface plating. Radiological and functional outcomes were assessed at regular intervals. The follow-up details and the complications and need for implant removal were collected from the hospital records.

Results: Our study included 60 patients (male-35 and female-25). The mean age was 41.7 ± 10.5 years. In all, 28 (46.7%) patients received lateral surface plating and 32 (53.3%) patients received posterior surface plating. The mean time gap between the injury and the surgery was significantly more among patients who underwent lateral plate insertion (P < .001). The mean operative time required for both the procedures was comparable, hence nonsignificant (P = .576). The mean American Orthopaedic Foot and Ankle Society score (AOFAS) after 2 years of operation was significantly higher for posterior plate insertion (P = .014). The complication rates as well as the implant removal rates were higher in patients with lateral plating (P < .05).

Conclusion: Posterior surface plating can be considered as the procedure of choice for isolated type B Weber lateral malleolus fractures with respect to better functional outcome, lesser complications rates, and need for implant removal.

Level of evidence: Level III: Economic/decision.