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These
are isolated fractures of the lateral malleolus at the level of the syndesmosis
(transsyndesmotic). The .1 subgroup is a simple fracture, the .2 subgroup
has an associated rupture of the anterior syndesmosis and in the .3 subgroup
the fibular fracture is multifragmentary. |
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Ref.
Manual of Internal Fixation:
595 - 611.
Surgeon. MS, RO, LO. |
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Since
the distal fragment of the lateral malleolus is larger than in type A,
the treatment must be performed following the classical principles of
anatomic reduction, interfragmentary compression with a lag screw and
neutralization with a contoured plate, that can also provide some axial
compression. The use of a hook plate
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makes
easier its distal fixation; such a plate must be perfectly contoured for
its adaptation to the shape of the fibular cortex. In the B1.3 case, the
plate appears not to be contoured, however it was minimally contoured
for its adaptation to an almost straight malleolus.
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