Clinical Comparison of Minifragment Plates Versus Conventional Semitubular Plates for Fixation of Distal Fibula Fractures

HSS Journal Online First Article

John Gentile, DO
Department of Orthopaedic Surgery, Grant Medical Center, Columbus, OH

Benjamin C. Taylor, MD
Department of Orthopaedic Trauma and Reconstructive Surgery, Grand Medical Center, Columbus, OH

Raymond Chan, DO
Department of Orthopaedic Surgery, Grant Medical Center, Columbus, OH

Bruce French, MD
Department of Surgery, Grant Medical Center, Columbus, OH


Although operative stabilization of unstable distal fibula fractures is frequently performed and discussed, the ideal implant and technique for these injuries is still debated.

The purpose of this study was to determine if minifragment plating of distal fibula fractures would clinically provide equivalent fixation and cost and minimize hardware prominence when compared with standard one-third tubular plating.

A retrospective review was conducted on 44 patients who had undergone operative stabilization of a displaced fibula fracture. Inclusion required fibula fixation with either a traditional one-third semitubular plate or a 2.7-mm minifragment plate. Retrospective review of the patient demographics, injury and surgical variables, and radiographs was completed by two surgeons not involved with the patients’ original care.

The minifragment group demonstrated equivalency in maintenance of fracture reduction relative to standard tubular plating. Both groups were able to maintain the talocrural angle with less than 1° of change from initial postoperative to final postoperative radiographs. No significant differences were seen in postoperative hardware irritation between groups.

Use of a minifragment plating system for displaced fibula fractures appears to be safe but comes with the significant potential added cost of the technology. Interestingly, no significant differences were seen in implant-related irritation or implant removal, but further investigation with a larger study population would help better determine these outcomes.

Level of Evidence: Level III: Retrospective Cohort Study
All work was done at Grant Medical Center, Columbus, OH, USA

This Online First article was published online in March 2015.
View the full HSS Journal article at

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.


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