A comparison of complication rates between locking and non-locking plates in distal fibular fractures

Abstract

Background: Locking compression plates have become increasingly popular in orthopaedic surgery. However, the gold standard of treatment for distal fibular fractures remains fixation with a non-locking one-third tubular plate. It has been reported that locking plates in distal fibular fractures are associated with an increased complication rate.

Hypothesis: The objective of this study is to assess the complication rates of locking versus non-locking plates in patients who underwent surgical fixation of distal fibular fractures.

Materials & methods: A retrospective analysis of closed distal fibular fractures that underwent surgical repair over a 2-year period with either a locking or non-locking plate was undertaken, analysing the groups for both wound and overall postoperative complications.

Results: A total of 160 patients were treated over 2 years, of which 129 and 31 patients were treated with non-locking and locking plates respectively. There was no significant difference between the non-locking and locking plates overall complication rates (13.5% versus 15.4%, p=0.76) or wound complication rates (3.97% versus 3.85%, p=1.00).

Discussion: Distal fibular fractures managed with locking plates do not have a higher complication rate in comparison to those managed with non-locking plates.

Level of evidence: III (case control study).

Keywords: Ankle fracture; Complications; Locking plates; Non-locking plates.