Use of a Locked Fibular Plate for Fixation of a Vertical Shear Medial Malleolus Fracture: A Case Report

Vertical shear fractures of the medial malleolus are less common than transverse fractures. These fractures are often treated with lag screws, posteromedial buttress plating, antiglide plates, and neutralization plates with screws. We report on a 37-year-old male who had fractured his ankle after tripping and falling into a ditch. Initially, the patient was treated with closed reduction and a splint for a trimalleolar fracture with a laterally subluxed talus. However, on review of his preoperative radiographs and computed tomography studies, we confirmed a medial malleolus fracture with a vertical shear pattern and communition. Recently, a contoured fibular locking plate has been developed. We considered this plate to be effective for containing the bone in part because of its broader plate design. We present a case in which a fibular locking plate was used successfully as a neutralization plate as an alternative fixation method for a vertical shear medial malleolar fracture.