Management of complex fibular fractures: double plating of fibular fractures

Complex fibular fractures as a result of either high-energy mechanisms or advanced age can be difficult to manage as significant comminution can preclude standard operative techniques. Furthermore, the maintenance of osseous reduction postoperatively throughout convalescence can present an equivalent challenge. Strict weightbearing restrictions in the elderly and the noncompliant postoperatively convey an additional risk of potential failure. We present a technique that has offered additional reassurance in these instances. We retrospectively evaluated 25 consecutive patients who had undergone this fibular double plating technique and evaluated the patient outcomes to determine whether this technique conferred any additional risk when weighed against its benefits. All 25 patients underwent benign postoperative courses. No additional operations were performed as a result of this technique. No patient undergoing this technique complained of any hardware irritation, and no hardware removal was required. This double plating technique may confer additional stability to fracture patterns that are inherently unstable. It does not appear to increase the incidence of hardware removal or irritation, and patient morbidity remained low. Based on our results, we advocate this technique especially for comminuted fracture patterns.