Antiglide plate fixation

Antiglide plate fixation is an open reduction internal fixation (ORIF) technique used in oblique diaphyseal fractures of the distal fibula. 

Usage

They are used to counteract vertical shear forces during axial loading in the diaphyseal bone and to prevent sliding/shortening of the fracture fragments.

Indications

One of the main indications is the fixation of oblique lateral malleolar fractures ¹.

Procedure

The antiglide plate fixation technique comprises the following ²:

• intra-operative contouring or bending one end towards the oblique fracture plane
• placement of the plate facing the oblique part of the fracture plane (commonly posterolateral or posterior in lateral malleolar fractures)
• screw fixation of proximal screws and lag screws

Complications

Complications of antiglide plate fixation of the lateral malleolus include the following ²:

• peroneal tendon injury
• hardware failure

Radiographic features

Plate position and fracture healing can be assessed with Mortise and lateral views of the ankle.

Radiological report

The radiological report should include the description of the following features ¹:

• loosening
• callus formation
• implant displacement
• plate fracture

Outcomes

Open reduction internal fixation of oblique lateral malleolar (Weber type B) fracture with an antiglide plate fixation from the posterolateral aspect and additional fracture compression with lag screws inserted through the plate offer increased torsional stability ³. It can be combined with screw fixation of tibial or fibular avulsion fractures or syndesmotic screw fixation.