Summary The plate is contoured to fit the anatomy of the distal fibula, aiding in precise placement and alignment, which is crucial for restoring normal biomechanics and reducing soft tissue irritation. Typically indicated for fractures in the distal fibula, particularly comminuted or complex distal fibular fractures, fractures requiring stable fixation to restore joint alignment, and Situations where posterior and lateral stability is compromised. Requires a posterolateral approach, which provides direct access to the fracture site but also necessitates careful handling of surrounding soft tissues.. Design & Biomechanics Anatomically Contoured the plate is contoured to fit the anatomy of the distal fibula, aiding in precise placement and alignment, which is crucial for restoring normal biomechanics and reducing soft tissue irritation. Locking and Non-locking Screws It accommodates both locking and non-locking screws, offering flexibility in fixation. Locking screws provide additional stability, especially in osteoporotic or comminuted bone, while non-locking screws allow for compression at the fracture site. Low-profile Design The plate has a slim profile to minimize soft tissue irritation, which is particularly beneficial for patients with limited soft tissue coverage in this area. Posterolateral Placement Positioned on the posterolateral aspect of the fibula, this plate is ideal for stabilizing fractures in this specific region, offering targeted support to the distal fibula and lateral malleolus. Multi-planar Screw Configuration this allows for optimal fixation and stability, enhancing outcomes in challenging fracture patterns. Indications Typically indicated for fractures in the distal fibula, particularly Comminuted or complex distal fibular fractures Fractures requiring stable fixation to restore joint alignment Situations where posterior and lateral stability is compromised Clinical Indications Ankle fractures Pilon fractures Approach Posterolateral approach which provides direct access to the fracture site but also necessitates careful handling of surrounding soft tissues. Placement The distal portion of this plate should be placed so the 2.7mm cluster is centered over the Posterolateral metaphyseal fibula, just proximal to the peroneal groove (Confirm there is no overhang over the edge of the distal fibula) When placed correctly, the distal aspect of the plate should not contact the peroneal tendons. This plate sits on the edge of the fibula, at 45° posterior from the lateral side. Posterolateral plate placement helps to neutralize forces for SER (supination external rotation) fracture patterns, while screw hole placement allows for fixation of these fragments Fit Designed with the use of SOMA: Stryker Orthopedics Modeling and Analytics1 SOMA includes a database with CT scans from hospitals across the world and state-of-the-art algorithms to mine the data for shape variability, bone density, and implant fit. The SOMA bone database contains a collection of 5570 and growing clinical CT scans and contains over 34,600 3D bone models Plate rotation allows for placement along the posterolateral shaft of the fibula while buttressing the distal fibula in spiral and oblique fracture patterns The distal cluster is tapered to reduce potential of soft tissue irritation and reduce plate prominence over the distal fibula The low profile 2.0mm distal end and 2.6mm shaft are designed to reduce the potential for soft tissue irritation Designed for buttressing of oblique or supination external rotation ankle fractures and to treat distal fibula fractures and the syndesmosis Pangea Distal Fibula plates were found to sit closer to the bone than competitive VA LCP plates, demonstrating superior fit1 Technical specifications Standard plate lengths: 4-15 hole (81-235mm) Thickness: 2.0mm distal, 2.6mm shaft Left and right anatomic plate options Screws T8 Screw Platform T8 Screw Platform Multiaxial locking 2.7 8-80mm Cortex 2.7 8-80mm Washer Description T15 Screw Platform Classification System Advanced Type I Description I d Type II Description II d Type III Description III d Differential Differential A key findings that differentiate topic from differential A found with topic key finding A found with differential A key finding A Differential B key findings that differentiate topic from differential B found with topic key finding A found with differential key finding A key finding C Diagnosis Made Treatment Nonoperative observation +/- physical therapy indications techniques outcomes immobilization alone indications timing modalities techniques outcomes closed reduction and immobilization indications techniques outcomes Operative emergent radical debridement and broad-spectrum IV antibiotics indications antibiotics techniques irrigation & debridement, soft tissue management, and provisional fixation indications timing techniques outcomes closed reduction and external fixation (ExFix) (+/- limited internal fixation) indications timing techniques outcomes closed reduction percutaneous pinning (CRPP) indications timing techniques outcomes open reduction indications postoperative open reduction internal fixation (ORIF) indications timing approaches techniques outcomes postoperative intramedullary nail fixation (IMN) indications contraindications timing techniques outcomes arthroplasty indications timing techniques outcomes fragment excision indications outcomes limb salvage resection and chemotherapy indications contraindications timing techniques outcomes amputation indications nerve release and debridement indications contraindications techniques outcomes Techniques Emergency room indications techniques Immobilization Alone with Splint & Functional Bracing indications technique pros/cons complications Closed reduction and immobilization indications reduction immobilization Chemotherapy administration Urgent irrigation & debridement with provisional vs. definitive fixation (I&D) indications techniques Temporizing external fixation (ExFix) indications Closed reduction percutaneous pinning (CRPP) indications approach technique complications (ONLY if specific to this treatment) Closed Reduction and External Fixation (ExFix) indications Open reduction internal fixation (ORIF) indications approach technique advanced techniques complications Intramedullary Nailing & Fixation (IMN) indications approach techniques complications postoperative care Arthroscopy indication approach basic technique advanced technique Arthroplasty indications approach technique techniques - advanced basic complications advanced complications Wide Resection indications approach techniques complications Repair indications approaches techniques complications Reconstruction indications approach technique complications Arthrodesis indication approach techniques complications Osteotomy indications Nerve Denervation, Decompression Release, and Debridement open arthroscop Amputation approach technique Complications Postoperative Anemia, Blood Loss incidence risk factors diagnosis treatment Surgical Site Infection (SSI) incidence risk factors diagnosis treatment tested treatment in bold blue indications Nerve Injury incidence risk factors diagnosis treatment tested treatment in bold blue indications indication A Nonunion incidence risk factors diagnosis treatment Recurrent Instability incidence risk factors diagnosis treatment Failure of Treatment Effect / Persistent Pain incidence risk factors diagnosis treatment Stiffness / Loss of Motion / Arthrofibrosis / Heterotopic Ossification incidence risk factors diagnosis treatment Hardware Failure incidence risk factors diagnosis treatment Posttraumatic Arthritis incidence risk factors diagnosis treatment Prognosis Natural history of disease / Prognosis without treatment Prognostic variable