الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
One out of ten fractures of the human skeleton is a fracture involving the ankle bones, thus it is considered the second most common fracture involving the lower limb.1,2 Knowledge of the management of such extremely common injuries is a must for each orthopaedic surgeon.
Using plain radiography, the stability of ankle fractures can be judged, and the type determined through a wide variety of classifications including the Lauge Hansen 3 and Weber 4 classifications.5 Stable malleolar fractures are managed nonoperatively or operatively according to the degree of fracture displacement as well as different patient characteristics. Unstable ankle fractures requiring accurate anatomical restoration of normal joint congruity are often stabilized through one of the many open reduction and internal fixation techniques.
Traditionally, fixation of the fractured fibular malleolus involved the utilization of a laterally placed tubular plate.6 Some fracture configurations allow the additional use of lag screws to provide additional interfragmentary compression and stability. However, prominent hardware complaints with overlying soft tissue compromise have been a constant menace.
Posteriorly placed tubular plates acting as antiglide plates provide even more stability, however this technique entailed more surgical dissection of the peronei and risked irritating them by the plate.6,7
Another popular option is the fixation with an intramedullary implant such as a retrograde fibular nail or screw especially in patients with hazardous soft tissue conditions that hinder the conventional open reduction and plate fixation techniques.8,9
Lag screws only fixation of long oblique lateral malleolus fractures provides enough compression and stability for fracture healing and union without the need for an extensive soft tissue dissection or additional metalware.10