Modified use of proximal humeral interlocking plate (PHILOS) in lateral malleolus fracture, functional and radiological outcome in series of 13 cases.

BACKGROUND: Lateral malleolus fracture can occur alone or is associated with the fracture of the medial malleolus leading to ankle instability. Treatment is aimed to achieve anatomical reduction and ensure stability. Compared to non-locking plate locking plate provide stable construct and compromise bone vascularity less. However, there is increase wound complication with locking plates than non-locking plates. PHILOS plate combines the principles of fixation with a conventional plate with those of locking screws. The benefits of this implant are that it gives enhanced purchase in osteopenic bone. It is the first case series of studying the outcomes of modified use of PHILOS plate in lateral malleolus fracture.

MATERIALS AND METHOD: This is a non-commercialized retrospective case series which were done by a single surgeon at our university tertiary-care level-1 trauma hospital between May 2013 to August 2017. Cases of lateral malleolus fracture fixed with PHILOS included. Functional and radiological outcome were recorded from patients' files and radiographs.

RESULTS: Out of 13 patients 1 patient was lost to follow up. Mean time to union was 8.5 weeks. One patient developed superficial surgical site infection and implant was removed in 2 patients. Mean postoperative Olerud-Molander Ankle Score was 88.6 at last follow up.

CONCLUSION: Modified use of PHILOS is neither the only nor the best means of achieving union, but rather it can offer significant advantages over previously described techniques and is a reasonable option in case of lateral malleolus fracture.