Practical: Lag-Screw and Neutralisation Plating of Lateral Malleolus
In an appropriately marked and consented anaesthetised patient.
I would complete the WHO checklist.
Patient would be supine on the table with sandbag under the ipsilateral limb.
Torniquet to 300mmHg
Incision 10cm in length over lateral malleolus.
Clean fracture edges
Reduce fracture with crocodile clamp
Lag screw + neutralisation plate
Closure in layers
- Must be perpendicular to fracture site
- Drill (3.5mm through first cortex)
- Insert 2.5mm into proximal drill hole)
- Drill far cortex
- Tap if not self tapping
- Insert screw (screw will only engage the distal bone leading to interfragmentary compression)