One or two lag screws for fixation of Danis-Weber type B fractures of the ankle

Background: There are many limitations in using the plate for fixation of lateral malleolar fractures of the ankle. Methods: This study prospectively reviewed 60 of 72 consecutive patients with an average follow up of 3.8 years who had Danis-Weber type B ankle fractures that were treated with one or two 3.5-mm cortical lag screws without plate fixation. Results: A stable anatomic reduction was obtained in 57 cases (95%). The average time to healing by radiograph was 3.1 months. There were two delayed unions and no nonunions. Joint space narrowing was found in one case. Clinical assessment was satisfactory in 56 of the patients (93%). Conclusion: Noncomminuted Danis-Weber Type B ankle fractures can be successfully treated without the risk of lateral plating, which includes cartilage damage caused by penetration of the ankle joint, increased periosteal dissection, and the risk of subsequent hardware removal.