May 28, 2009

2.7/3.5 mm LCP Lateral Distal Fibula

Philip Kregor

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The 2.7/3.5 mm LCP lateral distal fibula is an anatomically designed plate for the treatment of fractures, osteotomies, and nonunions of the metaphyseal and diaphyseal region of the distal fibula, especially in osteopenic bone.

The plate has an anatomically precontoured head and a low-profile design. It comes in right and left versions with lengths from 3 holes (73 mm) up to 15 holes (229 mm) and is available in stainless steel.

Metaphyseal fixation can be achieved by five coaxial distal locking holes in the plate head which use threaded interface to rigidly fix locking screws. These combination holes also accept standard cortex screws. Overall the plate head can either take 2.4 mm cortex screws, self-tapping (6-40 mm), 2.4 mm locking screws, self-tapping (6-30 mm), 2.7 mm cortex screws, self-tapping (6-55 mm), or 2.7 mm locking screws, selftapping (10-55 mm). A recess in the top of distal holes seats cortex screw heads to minimize cortex screw prominence. Also the locking screw heads are recessed. Four K-wire holes in the plate head accept 2.0 mm K-wires for provisional fixation.

For diaphyseal fixation the combination holes use the threaded side to hold locking screws at predetermined fixed angles, and the DCU side for conventional plating with nonlocking screws. An elongated combination hole holds the plate to the bone while allowing plate position adjustments. Plates with six or more holes have two elongated combination holes. The plate shaft accepts 3.5 mm locking screws, self-tapping (10-95 mm), 3.5 mm cortex screws, self-tapping (10-150 mm), and 4.0 mm cancellous screws with full or partial thread (10-100 mm).

The T8 and T15 StarDrive, 2.5 mm hex recess in the screws provides optimum torque transmission.

Cases provided by Mathew Graves, Jackson, USA.

Case 1: 55-year-old male fell off a horse and sustained an open pronation abduction ankle fracture dislocation.

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Case 2: 80-year-old morbidly obese female. Post motor vehicle collision with open proximal third tibial shaft fracture, closed lateral malleolar fracture and fibular neck fracture, and distal tibiofibular syndesmotic disruption with ankle capsular injury.

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