Surgical Discussion

Patient positioning:  Supine with a bump underneath ipsilateral hip while doing ORIF of Lateral malleolus.

Anatomical surgical approach:  Anterolateral for Lateral malleolus and anteromedial for Medial malleolus.

On exploration of fractures there was very little callous formation. Osteotomes were used to sharply gain access to fracture edges which were freshened. Articular reduction of medial malleolus was achieved and preliminary fixation done by 1.8 mm K-wire. Lateral malleolus was fixed by Locked Distal fibula plate. Medial malleolus was fixed by buttress one- third tubular plate and cannulated cancellous screw.

Postoperative protocol:   Touch down weight bearing for 4 weeks

Orthopaedic implants used:   4.5 mm Cannulated Cancellous Screw Locked Distal fibular plate One-third tubular plate