Percutaneous plating of ankle fractures

The management of distal tibial fractures can be difficult, and requires careful preoperative planning. Fracture pattern, soft tissue injury, and bone quality critically influence the selection of fixation technique.¹ Several surgical methods have been described for the management of these fractures, including external fixation, intramedullary nailing, and plate fixation. External fixation may result in inaccurate reduction, malunion or nonunion, and pin tract infection.²Intramedullary nailing is considered the standard method to manage operatively diaphyseal fractures of the tibia, but the distal tibia poses concerns regarding the stability of fixation, the risk of secondary displacement of the fracture on insertion of the nail, breakage of nails and locking screws, and final alignment of the tibia.