Trimalleolar Ankle Fracture Treatment Using Plate and Screw Fixation – Ankle Plating System 3 Case Study

Jeffrey Seybold, MD – A 57-year-old man sustained a trimalleolar ankle fracture-dislocation that was treated with the Acumed Ankle Plating System 3. Treatment: The patient was positioned prone on the operating table. A standard posterolateral approach was used and the FHL muscle belly and tendon were reflected medially to expose the posterior distal tibia. The peroneal muscle bellies and tendons were mobilized laterally to allow adequate exposure of the posterior fibula. Anatomic reduction of the distal fibula fracture was achieved first, and the fracture was temporarily stabilized with a K-wire. The wire is used initially to maintain adequate fibular length and fracture reduction while allowing the surgeon to visualize the posterior malleolus on a lateral fluoroscopic image. Plating the fibula first will block the view of the posterior malleolus and is not recommended.