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

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.

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.

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).

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 III: Economic/decision.