Effectiveness comparison of a new hook-shaped anatomical locking plate and conventional anatomical locking plate in treatment of Danis-Weber type A lateral malleolus fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CUI Chengcheng , FU Bingjin , YANG Weiqiang , LIU Ying ,  ZHU Xiaodong , CUI Chengcheng , FU Bingjin , YANG Weiqiang , LIU Ying ,  ZHU Xiaodong

Department of Foot and Ankle Surgery, Affiliated Hospital of Binzhou Medical University, Binzhou Shandong, 256603, P. R. China;

Corresponding?author：

ZHU Xiaodong, Email: byfyzxd@126.com; ZHU Xiaodong, Email: byfyzxd@126.com

Keywords：

Lateral malleolus fracture; ankle joint; internal fixation; new hook-shaped anatomical locking plate; lateral malleolus anatomical locking plate

DOI：

10.7507/1002-1892.202312028

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effectiveness of a new hook-shaped anatomical locking plate in the treatment of Danis-Weber type A lateral malleolus fractures. Methods A retrospective analysis was performed on the clinical data of 45 patients with Danis-Weber type A lateral malleolus fractures who met the selection criteria between November 2020 and November 2022. According to the surgical methods, they were divided into the observation group (treated with the new hook-shaped anatomical locking plate, 23 cases) and the control group (treated with the conventional lateral malleolus anatomical locking plate, 22 cases). There was no significant difference in baseline data such as gender, age, cause of injury, Danis-Weber type of fracture, time from injury to operation, and combined ligament injury between the two groups (P>0.05). The operation time, partial weight-bearing time, return to work time, and postoperative complications were recorded and compared between the two groups. The function and pain of ankle joint were evaluated by the range of motion of ankle dorsiflexion, plantarflexion, varus, valgus, and visual analogue scale (VAS) score at 1 and 3 months after operation, and at last follow-up, and the American Orthopaedic Foot and Ankle Society (AOFAS) score at 3 months after operation and at last follow-up. Results All patients were followed up 10-18 months (mean, 15.1 months). There was no significant difference in operation time between the two groups (P>0.05); the postoperative partial weight-bearing time and return to work time of the observation group were significantly earlier than those of the control group (P<0.05). During the follow-up, there was 1 case of joint stiffness in the observation group, and 1 case of joint surface displacement, 1 case of joint stiffness, and 1 case of traumatic arthritis in the control group. There was no significant difference in the incidences of complications between the two groups (P>0.05). With the extension of time after operation, the range of motion of ankle dorsiflexion, plantarflexion, varus, valgus, and VAS score of the two groups gradually improved, and there were significant differences between different time points (P<0.05); At 1 and 3 months after operation, the above indexes in the observation group were significantly better than those in the control group (P<0.05), and there was no significant difference between the two groups at last follow-up (P>0.05). The difference of AOFAS score between the last follow-up and 3 months after operation in the observation group was significantly better than that in the control group (P<0.05). Conclusion Compared with the conventional lateral malleolus anatomical locking plate, the new hook-shaped anatomical locking plate has a more reliable fixation effect in the treatment of Danis-Weber type A lateral malleolus fracture, which is conducive to early functional exercise of the ankle joint, so that patients can bear weight earlier and return to work earlier, and the operation time is not significantly prolonged, and the effectiveness is satisfactory.

Citation： CUI Chengcheng, FU Bingjin, YANG Weiqiang, LIU Ying, ZHU Xiaodong. Effectiveness comparison of a new hook-shaped anatomical locking plate and conventional anatomical locking plate in treatment of Danis-Weber type A lateral malleolus fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(4): 438-443. doi: 10.7507/1002-1892.202312028 Copy

1.	Grisdela P, Williams C, Challa S, et al. Screw-only fibular construct for Weber B ankle fractures: A retrospective clinical and cost comparison to assess feasibility for resource-limited settings. Injury, 2022, 53(12): 4146-4151.
2.	Grisdela P, Williams C, Challa S, et al. Screw-only fibular construct for Weber B ankle fractures: A retrospective clinical and cost comparison to assess feasibility for resource-limited settings. Injury, 2022, 53(12): 4146-4151.
3.	Xia D, Zhang Y, Ou T, et al. Combination of mini locking plate and nitinol arched shape-memory connector for purely lateral malleolus fractures: technique and clinical results. Ann Transl Med, 2020, 8(23): 1573. doi: 10.21037/atm-20-4055.
4.	Xia D, Zhang Y, Ou T, et al. Combination of mini locking plate and nitinol arched shape-memory connector for purely lateral malleolus fractures: technique and clinical results. Ann Transl Med, 2020, 8(23): 1573. doi: 10.21037/atm-20-4055.
5.	王迪一, 馮坤寧, 王根, 等. Trimed鉤鋼板固定外踝骨折. 中國矯形外科雜志, 2022, 30(2): 184-187.
6.	王迪一, 馮坤寧, 王根, 等. Trimed鉤鋼板固定外踝骨折. 中國矯形外科雜志, 2022, 30(2): 184-187.
7.	Ziegler P, Bahrs C, Konrads C, et al. Ankle fractures of the geriatric patient: a narrative review. EFORT Open Rev, 2023, 8(1): 1-10.
8.	Ziegler P, Bahrs C, Konrads C, et al. Ankle fractures of the geriatric patient: a narrative review. EFORT Open Rev, 2023, 8(1): 1-10.
9.	唐一丁, 梁曉軍, 趙宏謀, 等. 踝關節骨折中腓骨骨折的診療進展. 中國修復重建外科雜志, 2022, 36(1): 117-121.
10.	唐一丁, 梁曉軍, 趙宏謀, 等. 踝關節骨折中腓骨骨折的診療進展. 中國修復重建外科雜志, 2022, 36(1): 117-121.
11.	Wang B, Hu M, Wan D, et al. Treatment of posterior malleolar fractures in elderly individuals with Kirschner wire tension band fixation. J Am Podiatr Med Assoc, 2022, 112(4): 20-250.
12.	Wang B, Hu M, Wan D, et al. Treatment of posterior malleolar fractures in elderly individuals with Kirschner wire tension band fixation. J Am Podiatr Med Assoc, 2022, 112(4): 20-250.
13.	Pearce O, Al-Hourani K, Kelly M. Ankle fractures in the elderly: Current concepts. Injury, 2020, 51(12): 2740-2747.
14.	Pearce O, Al-Hourani K, Kelly M. Ankle fractures in the elderly: Current concepts. Injury, 2020, 51(12): 2740-2747.
15.	宋澤輝. 不同內固定方式治療Weber A型腓骨遠端骨折的療效. 臨床骨科雜志, 2020, 23(1): 128-130.
16.	宋澤輝. 不同內固定方式治療Weber A型腓骨遠端骨折的療效. 臨床骨科雜志, 2020, 23(1): 128-130.
17.	Weng Q, Lin C, Liu Y, et al. Biomechanical analysis of a novel syndesmotic plate compared with traditional screw and suture button fixation. J Foot Ankle Surg, 2020, 59(3): 522-528.
18.	Weng Q, Lin C, Liu Y, et al. Biomechanical analysis of a novel syndesmotic plate compared with traditional screw and suture button fixation. J Foot Ankle Surg, 2020, 59(3): 522-528.
19.	Bulut T, Gursoy M. Isolated medial malleolus fractures: Conventional techniques versus headless compression screw fixation. J Foot Ankle Surg, 2018, 57(3): 552-556.
20.	Bulut T, Gursoy M. Isolated medial malleolus fractures: Conventional techniques versus headless compression screw fixation. J Foot Ankle Surg, 2018, 57(3): 552-556.
21.	Bilgetekin YG, ?atma MF, ?ztürk A, et al. Comparison of different locking plate fixation methods in lateral malleolus fractures. Foot Ankle Surg, 2019, 25(3): 366-370.
22.	Bilgetekin YG, ?atma MF, ?ztürk A, et al. Comparison of different locking plate fixation methods in lateral malleolus fractures. Foot Ankle Surg, 2019, 25(3): 366-370.
23.	Evola FR, Di Fede GF, Evola G, et al. Locking plates for distal fibula fractures in young and elderly patients: A retrospective study. World J Orthop, 2023, 14(7): 540-546.
24.	Evola FR, Di Fede GF, Evola G, et al. Locking plates for distal fibula fractures in young and elderly patients: A retrospective study. World J Orthop, 2023, 14(7): 540-546.
25.	Sop A, Kali M, Spindel JF, et al. Retrospective analysis of locked versus non-locked plating of distal fibula fractures. Injury, 2023, 54(2): 768-771.
26.	Sop A, Kali M, Spindel JF, et al. Retrospective analysis of locked versus non-locked plating of distal fibula fractures. Injury, 2023, 54(2): 768-771.
27.	Hasan O, Fahad S, Umer M, et al. Modified use of proximal humeral interlocking plate (PHILOS) in lateral malleolus fracture, functional and radiological outcome in series of 13 cases. Int J Surg, 2018, 56: 79-82.
28.	Hasan O, Fahad S, Umer M, et al. Modified use of proximal humeral interlocking plate (PHILOS) in lateral malleolus fracture, functional and radiological outcome in series of 13 cases. Int J Surg, 2018, 56: 79-82.
29.	Bai L, Zhou W, Zhang W, et al. Correlation factors for distal syndesmosis ossification following internal fixation of ankle fracture. Sci Rep, 2018, 8(1): 12698. doi: 10.1038/s41598-018-30672-7.
30.	Bai L, Zhou W, Zhang W, et al. Correlation factors for distal syndesmosis ossification following internal fixation of ankle fracture. Sci Rep, 2018, 8(1): 12698. doi: 10.1038/s41598-018-30672-7.
31.	Zhenhua F, Waizy H, Ming X, et al. Lateral malleolus hook plate for comminuted Weber A and B fractures: A retrospective study. Indian J Orthop, 2013, 47(4): 364-369.
32.	Zhenhua F, Waizy H, Ming X, et al. Lateral malleolus hook plate for comminuted Weber A and B fractures: A retrospective study. Indian J Orthop, 2013, 47(4): 364-369.
33.	楊子來, 王玲玲, 韓新波, 等. 提高外踝粉碎骨折復位質量的經驗. 中國矯形外科雜志, 2023, 31(12): 1145-1147.
34.	楊子來, 王玲玲, 韓新波, 等. 提高外踝粉碎骨折復位質量的經驗. 中國矯形外科雜志, 2023, 31(12): 1145-1147.
35.	Meijer DT, Gevers Deynoot BDJ, Stufkens SA, et al. What factors are associated with outcomes scores after surgical treatment of ankle fractures with a posterior malleolar fragment? Clin Orthop Relat Res, 2019, 477(4): 863-869.
36.	Meijer DT, Gevers Deynoot BDJ, Stufkens SA, et al. What factors are associated with outcomes scores after surgical treatment of ankle fractures with a posterior malleolar fragment? Clin Orthop Relat Res, 2019, 477(4): 863-869.
37.	Aiyer AA, Zachwieja EC, Lawrie CM, et al. Management of isolated lateral malleolus fractures. J Am Acad Orthop Surg, 2019, 27(2): 50-59.
38.	Aiyer AA, Zachwieja EC, Lawrie CM, et al. Management of isolated lateral malleolus fractures. J Am Acad Orthop Surg, 2019, 27(2): 50-59.
39.	Mococain P, Bejarano-Pineda L, Glisson R, et al. Biomechanical effect on joint stability of including deltoid ligament repair in an ankle fracture soft tissue injury model with deltoid and syndesmotic disruption. Foot Ankle Int, 2020, 41(9): 1158-1164.
40.	Mococain P, Bejarano-Pineda L, Glisson R, et al. Biomechanical effect on joint stability of including deltoid ligament repair in an ankle fracture soft tissue injury model with deltoid and syndesmotic disruption. Foot Ankle Int, 2020, 41(9): 1158-1164.
41.	張宇軒, 許亞軍, 張興飛. 帶鉤鋼板固定Danis-Weber A型外踝骨折. 中國矯形外科雜志, 2021, 29(24): 2282-2285.
42.	張宇軒, 許亞軍, 張興飛. 帶鉤鋼板固定Danis-Weber A型外踝骨折. 中國矯形外科雜志, 2021, 29(24): 2282-2285.
43.	Raschke MJ, Ochman S, Milstrey A. Ankle fractures in the elderly: Do we have new concepts? EFORT Open Rev, 2023, 8(5): 223-230.
44.	Raschke MJ, Ochman S, Milstrey A. Ankle fractures in the elderly: Do we have new concepts? EFORT Open Rev, 2023, 8(5): 223-230.
45.	Zhao JZ, Michalski MP, Ingall E, et al. Does screw order matter? A technique tip to prevent loss of fracture reduction during surgical fixation of lateral malleolus fractures. Arch Bone Jt Surg, 2023, 11(7): 453-457.
46.	Zhao JZ, Michalski MP, Ingall E, et al. Does screw order matter? A technique tip to prevent loss of fracture reduction during surgical fixation of lateral malleolus fractures. Arch Bone Jt Surg, 2023, 11(7): 453-457.
47.	Gopireddy R, Hafez AT, Khan MJ, et al. Comparison of complications, metalwork removal and cost between locking and tubular plates for lateral malleolus fractures fixation. Cureus, 2023, 15(3): e36181. doi: 10.7759/cureus.36181.
48.	Gopireddy R, Hafez AT, Khan MJ, et al. Comparison of complications, metalwork removal and cost between locking and tubular plates for lateral malleolus fractures fixation. Cureus, 2023, 15(3): e36181. doi: 10.7759/cureus.36181.
49.	Huang S, Zhu J, Xing H, et al. Finite element analysis and a pilot study of different fixation constructs for Danis-Weber A and B lateral malleolus fractures. BMC Musculoskelet Disord, 2023, 24(1): 981. doi: 10.1186/s12891-023-07115-0.
50.	Huang S, Zhu J, Xing H, et al. Finite element analysis and a pilot study of different fixation constructs for Danis-Weber A and B lateral malleolus fractures. BMC Musculoskelet Disord, 2023, 24(1): 981. doi: 10.1186/s12891-023-07115-0.
51.	Stake IK, R?der BW, Gregersen MG, et al. Higher complication rate after nail compared with plate fixation of ankle fractures in patients aged 60 years or older: a prospective, randomized controlled trial. Bone Joint J, 2023, 105-B(1): 72-81.
52.	Stake IK, R?der BW, Gregersen MG, et al. Higher complication rate after nail compared with plate fixation of ankle fractures in patients aged 60 years or older: a prospective, randomized controlled trial. Bone Joint J, 2023, 105-B(1): 72-81.

1. Grisdela P, Williams C, Challa S, et al. Screw-only fibular construct for Weber B ankle fractures: A retrospective clinical and cost comparison to assess feasibility for resource-limited settings. Injury, 2022, 53(12): 4146-4151.
2. Grisdela P, Williams C, Challa S, et al. Screw-only fibular construct for Weber B ankle fractures: A retrospective clinical and cost comparison to assess feasibility for resource-limited settings. Injury, 2022, 53(12): 4146-4151.
3. Xia D, Zhang Y, Ou T, et al. Combination of mini locking plate and nitinol arched shape-memory connector for purely lateral malleolus fractures: technique and clinical results. Ann Transl Med, 2020, 8(23): 1573. doi: 10.21037/atm-20-4055.
4. Xia D, Zhang Y, Ou T, et al. Combination of mini locking plate and nitinol arched shape-memory connector for purely lateral malleolus fractures: technique and clinical results. Ann Transl Med, 2020, 8(23): 1573. doi: 10.21037/atm-20-4055.
5. 王迪一, 馮坤寧, 王根, 等. Trimed鉤鋼板固定外踝骨折. 中國矯形外科雜志, 2022, 30(2): 184-187.
6. 王迪一, 馮坤寧, 王根, 等. Trimed鉤鋼板固定外踝骨折. 中國矯形外科雜志, 2022, 30(2): 184-187.
7. Ziegler P, Bahrs C, Konrads C, et al. Ankle fractures of the geriatric patient: a narrative review. EFORT Open Rev, 2023, 8(1): 1-10.
8. Ziegler P, Bahrs C, Konrads C, et al. Ankle fractures of the geriatric patient: a narrative review. EFORT Open Rev, 2023, 8(1): 1-10.
9. 唐一丁, 梁曉軍, 趙宏謀, 等. 踝關節骨折中腓骨骨折的診療進展. 中國修復重建外科雜志, 2022, 36(1): 117-121.
10. 唐一丁, 梁曉軍, 趙宏謀, 等. 踝關節骨折中腓骨骨折的診療進展. 中國修復重建外科雜志, 2022, 36(1): 117-121.
11. Wang B, Hu M, Wan D, et al. Treatment of posterior malleolar fractures in elderly individuals with Kirschner wire tension band fixation. J Am Podiatr Med Assoc, 2022, 112(4): 20-250.
12. Wang B, Hu M, Wan D, et al. Treatment of posterior malleolar fractures in elderly individuals with Kirschner wire tension band fixation. J Am Podiatr Med Assoc, 2022, 112(4): 20-250.
13. Pearce O, Al-Hourani K, Kelly M. Ankle fractures in the elderly: Current concepts. Injury, 2020, 51(12): 2740-2747.
14. Pearce O, Al-Hourani K, Kelly M. Ankle fractures in the elderly: Current concepts. Injury, 2020, 51(12): 2740-2747.
15. 宋澤輝. 不同內固定方式治療Weber A型腓骨遠端骨折的療效. 臨床骨科雜志, 2020, 23(1): 128-130.
16. 宋澤輝. 不同內固定方式治療Weber A型腓骨遠端骨折的療效. 臨床骨科雜志, 2020, 23(1): 128-130.
17. Weng Q, Lin C, Liu Y, et al. Biomechanical analysis of a novel syndesmotic plate compared with traditional screw and suture button fixation. J Foot Ankle Surg, 2020, 59(3): 522-528.
18. Weng Q, Lin C, Liu Y, et al. Biomechanical analysis of a novel syndesmotic plate compared with traditional screw and suture button fixation. J Foot Ankle Surg, 2020, 59(3): 522-528.
19. Bulut T, Gursoy M. Isolated medial malleolus fractures: Conventional techniques versus headless compression screw fixation. J Foot Ankle Surg, 2018, 57(3): 552-556.
20. Bulut T, Gursoy M. Isolated medial malleolus fractures: Conventional techniques versus headless compression screw fixation. J Foot Ankle Surg, 2018, 57(3): 552-556.
21. Bilgetekin YG, ?atma MF, ?ztürk A, et al. Comparison of different locking plate fixation methods in lateral malleolus fractures. Foot Ankle Surg, 2019, 25(3): 366-370.
22. Bilgetekin YG, ?atma MF, ?ztürk A, et al. Comparison of different locking plate fixation methods in lateral malleolus fractures. Foot Ankle Surg, 2019, 25(3): 366-370.
23. Evola FR, Di Fede GF, Evola G, et al. Locking plates for distal fibula fractures in young and elderly patients: A retrospective study. World J Orthop, 2023, 14(7): 540-546.
24. Evola FR, Di Fede GF, Evola G, et al. Locking plates for distal fibula fractures in young and elderly patients: A retrospective study. World J Orthop, 2023, 14(7): 540-546.
25. Sop A, Kali M, Spindel JF, et al. Retrospective analysis of locked versus non-locked plating of distal fibula fractures. Injury, 2023, 54(2): 768-771.
26. Sop A, Kali M, Spindel JF, et al. Retrospective analysis of locked versus non-locked plating of distal fibula fractures. Injury, 2023, 54(2): 768-771.
27. Hasan O, Fahad S, Umer M, et al. Modified use of proximal humeral interlocking plate (PHILOS) in lateral malleolus fracture, functional and radiological outcome in series of 13 cases. Int J Surg, 2018, 56: 79-82.
28. Hasan O, Fahad S, Umer M, et al. Modified use of proximal humeral interlocking plate (PHILOS) in lateral malleolus fracture, functional and radiological outcome in series of 13 cases. Int J Surg, 2018, 56: 79-82.
29. Bai L, Zhou W, Zhang W, et al. Correlation factors for distal syndesmosis ossification following internal fixation of ankle fracture. Sci Rep, 2018, 8(1): 12698. doi: 10.1038/s41598-018-30672-7.
30. Bai L, Zhou W, Zhang W, et al. Correlation factors for distal syndesmosis ossification following internal fixation of ankle fracture. Sci Rep, 2018, 8(1): 12698. doi: 10.1038/s41598-018-30672-7.
31. Zhenhua F, Waizy H, Ming X, et al. Lateral malleolus hook plate for comminuted Weber A and B fractures: A retrospective study. Indian J Orthop, 2013, 47(4): 364-369.
32. Zhenhua F, Waizy H, Ming X, et al. Lateral malleolus hook plate for comminuted Weber A and B fractures: A retrospective study. Indian J Orthop, 2013, 47(4): 364-369.
33. 楊子來, 王玲玲, 韓新波, 等. 提高外踝粉碎骨折復位質量的經驗. 中國矯形外科雜志, 2023, 31(12): 1145-1147.
34. 楊子來, 王玲玲, 韓新波, 等. 提高外踝粉碎骨折復位質量的經驗. 中國矯形外科雜志, 2023, 31(12): 1145-1147.
35. Meijer DT, Gevers Deynoot BDJ, Stufkens SA, et al. What factors are associated with outcomes scores after surgical treatment of ankle fractures with a posterior malleolar fragment? Clin Orthop Relat Res, 2019, 477(4): 863-869.
36. Meijer DT, Gevers Deynoot BDJ, Stufkens SA, et al. What factors are associated with outcomes scores after surgical treatment of ankle fractures with a posterior malleolar fragment? Clin Orthop Relat Res, 2019, 477(4): 863-869.
37. Aiyer AA, Zachwieja EC, Lawrie CM, et al. Management of isolated lateral malleolus fractures. J Am Acad Orthop Surg, 2019, 27(2): 50-59.
38. Aiyer AA, Zachwieja EC, Lawrie CM, et al. Management of isolated lateral malleolus fractures. J Am Acad Orthop Surg, 2019, 27(2): 50-59.
39. Mococain P, Bejarano-Pineda L, Glisson R, et al. Biomechanical effect on joint stability of including deltoid ligament repair in an ankle fracture soft tissue injury model with deltoid and syndesmotic disruption. Foot Ankle Int, 2020, 41(9): 1158-1164.
40. Mococain P, Bejarano-Pineda L, Glisson R, et al. Biomechanical effect on joint stability of including deltoid ligament repair in an ankle fracture soft tissue injury model with deltoid and syndesmotic disruption. Foot Ankle Int, 2020, 41(9): 1158-1164.
41. 張宇軒, 許亞軍, 張興飛. 帶鉤鋼板固定Danis-Weber A型外踝骨折. 中國矯形外科雜志, 2021, 29(24): 2282-2285.
42. 張宇軒, 許亞軍, 張興飛. 帶鉤鋼板固定Danis-Weber A型外踝骨折. 中國矯形外科雜志, 2021, 29(24): 2282-2285.
43. Raschke MJ, Ochman S, Milstrey A. Ankle fractures in the elderly: Do we have new concepts? EFORT Open Rev, 2023, 8(5): 223-230.
44. Raschke MJ, Ochman S, Milstrey A. Ankle fractures in the elderly: Do we have new concepts? EFORT Open Rev, 2023, 8(5): 223-230.
45. Zhao JZ, Michalski MP, Ingall E, et al. Does screw order matter? A technique tip to prevent loss of fracture reduction during surgical fixation of lateral malleolus fractures. Arch Bone Jt Surg, 2023, 11(7): 453-457.
46. Zhao JZ, Michalski MP, Ingall E, et al. Does screw order matter? A technique tip to prevent loss of fracture reduction during surgical fixation of lateral malleolus fractures. Arch Bone Jt Surg, 2023, 11(7): 453-457.
47. Gopireddy R, Hafez AT, Khan MJ, et al. Comparison of complications, metalwork removal and cost between locking and tubular plates for lateral malleolus fractures fixation. Cureus, 2023, 15(3): e36181. doi: 10.7759/cureus.36181.
48. Gopireddy R, Hafez AT, Khan MJ, et al. Comparison of complications, metalwork removal and cost between locking and tubular plates for lateral malleolus fractures fixation. Cureus, 2023, 15(3): e36181. doi: 10.7759/cureus.36181.
49. Huang S, Zhu J, Xing H, et al. Finite element analysis and a pilot study of different fixation constructs for Danis-Weber A and B lateral malleolus fractures. BMC Musculoskelet Disord, 2023, 24(1): 981. doi: 10.1186/s12891-023-07115-0.
50. Huang S, Zhu J, Xing H, et al. Finite element analysis and a pilot study of different fixation constructs for Danis-Weber A and B lateral malleolus fractures. BMC Musculoskelet Disord, 2023, 24(1): 981. doi: 10.1186/s12891-023-07115-0.
51. Stake IK, R?der BW, Gregersen MG, et al. Higher complication rate after nail compared with plate fixation of ankle fractures in patients aged 60 years or older: a prospective, randomized controlled trial. Bone Joint J, 2023, 105-B(1): 72-81.
52. Stake IK, R?der BW, Gregersen MG, et al. Higher complication rate after nail compared with plate fixation of ankle fractures in patients aged 60 years or older: a prospective, randomized controlled trial. Bone Joint J, 2023, 105-B(1): 72-81.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness comparison of a new hook-shaped anatomical locking plate and conventional anatomical locking plate in treatment of Danis-Weber type A lateral malleolus fractures

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