Distal fibula locked plate versus nonlocked plate for treatment of Danis Weber type B fracture comparative prospective study

Background
Ankle fractures are one of the most common fractures affecting both the young and old. they are the third most common fracture in elderly patients. The appropriate method of fixation of those fractures is debatable especially for osteoporotic patients, osteoprosis renders commonly used internal fixation methods technically demanding and prone to failure.
Aim
To compare distal fibula locked plate to nonlocked plate for treatment of Danis Weber type B fracture regarding union rate, union time, operation time, failure rate, and other complications.
Patients and methods
This study was conducted on 100 patients classified as a Weber B traumatic fracture. Fifty patients were undergoing open reduction internal fixation (ORIF) using locking plates (group A) and patients underwent ORIF using nonlocking plates (group B). The following parameters were assessed in both groups range of motion, union rate, union time, complications, operation time, American orthopedic foot and ankle society and failure rate.
Results
There was no statistically significant difference between both groups in operation time and blood loss. Length of hospital stays (days) and Time to full weight bearing, union time was lower in group A than group B. American orthopedic foot and ankle society was higher in group A than in group B. There was no statistically significant difference in range of motion (extension, flexion) between both groups. The rate of loosening of the distal screw and implant removal was higher in group B than in group A.
Conclusion
No statistically significant difference was found between both groups regarding functional, radiological outcomes, and complications in patients less than or equal to 60 years old. Therefore, one-third plate is preferred in a young age in terms of cost-effectiveness. In patients over 60 years old, using the locking plates yields better stability, and functional and radiological outcome than non-locking plates.