Comparison between antiglide plate and neutralization plate in fixation of weber B lateral malleolus oblique fracture : functional outcome and complications

Hosny, Ihab Aly; El Sayed, Islam Salah; Tarkhan, Sherif Adel; Ismail, Mohamed Kamal

doi:10.21608/arcmed.2025.370504.1103

Comparison between antiglide plate and neutralization plate in fixation of weber B lateral malleolus oblique fracture : functional outcome and complications

Document Type : Original Research

Authors

¹ Head of orthopedic department, Armed Forces College of Medicine, Cairo, Egypt

² Radiology department, Military medical academy, Cairo, Egypt

³ Orthopedic surgery department, Armed Forces College of medicine, Cairo, Egypt

⁴ Orthopaedic surgery department, Armed Forces College of medicine, Cairo, Egypt

10.21608/arcmed.2025.370504.1103

Abstract

Background: Ankle fractures are the second most frequent fracture of the lower limbs, Oblique Danis-Weber B fracture that is caused by supination-external rotation injuries is the most common pattern,the most commonly used methods of fixation are plating in either neutralization or antiglide fashion.

Aim of the study: To compare functional outcomes and complications between fixation of oblique weber B lateral malleolus fracture by antiglide versus neutralization technique.

Subjects and methods: This was a Randomized controlled trial (RCT), conducted on 58 adult patients with weber B lateral malleolus oblique fractures presented at Helmya Armed forces hospital.

Results: The 58 patients were divided into two groups, with 29 patients in each group. One group received fixation using the neutralization plate, while the other group received antiglide plate. Patients in both groups achieved full weight bearing at approximately 11 weeks. The majority of fractures in both groups united within 16 weeks. 3 months postoperatively, the American Orthopaedic Foot and Ankle Society score (AOFAS) were nearly identical. Ultrasonographic evidence of peroneal tendinopathy was higher in the antiglide plate group (20.7%) compared to the neutralization plate group (6.9%) with no significant difference between two groups.

Conclusion: Compared to lateral neutralization plating, antiglide plating for weber B lateral malleolus oblique fractures is preferable because it reduces the likelihood of hardware discomfort with a slightly increased risk of peroneal tendon irritation of no statiscal significance. Moreover, both techniques had similar functional outcome and union rate.

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