Summary VolitionTM Ankle Fracture Plates are available in six varieties: anatomic fibula plate, straight fibula plate, anatomic medial malleolar plate, posteromedial tibial plates (Type IIB), posterolateral tibial plates (Type IIA) and posterior tibial plates (Type III). the posterior tibial fracture plates are designed around the mason & molloy posterior malleolar fracture classification VolitionTM Plating System non-locking screws are compatible with washers and any screw hole in the plates. VolitionTM Plating System locking screws are compatible with any screw hole. Biological Materials Plates type II anodize plates produce anti-galling properties + Type III anodize screws result in minimizing coldwelding for easier implant removal, if required utilize softer plate material/alloy Indications Indications ankle fractures malleolar fractures distal fibula fractures medial malleolus fractures posterior malleolar fractures unstable fracture patterns displaced fractures comminuted fractures revision fixation Contraindications active infection severe osteoporosis compromised vascularity poor soft tissue implant hypersensitivity skeletal immaturity noncompliant patients Anatomy Osteology distal fibula login to view 2 more bullets medial malleolus login to view 1 more bullet posterior malleolus/posterior plafond fragments login to view 1 more bullet syndesmotic region login to view 2 more bullets Muscles lateral approach login to view 2 more bullets posterolateral corridor login to view 2 more bullets posteromedial corridor login to view 2 more bullets Ligaments deltoid ligament login to view 2 more bullets syndesmotic complex login to view 1 more bullet posterior capsule login to view 1 more bullet Nerves superficial peroneal nerve login to view 2 more bullets sural nerve login to view 2 more bullets tibial nerve branches login to view 2 more bullets Blood supply anterior tibial contribution login to view 1 more bullet peroneal contribution login to view 1 more bullet posterior tibial contribution login to view 2 more bullets Approach Medial and lateral malleolus use standard approaches and techniques for medial and lateral malleolar fracture fixation Posterior tibia/posterior malleolus summarize the manufacturer-depicted approach guidance tied to fracture type login to view 3 more bullets approach choice depends on fracture pattern, soft tissues, and surgeon judgment Technique Approach & fracture reduction expose the anatomy, then clean and reduce the fracture per standard fracture care and protocols provisional fixation login to view 3 more bullets Screw and washer fixation (without plate) when screws may be used without a plate login to view 1 more bullet washers login to view 2 more bullets lag technique reminder login to view 2 more bullets drilling + guides login to view 5 more bullets depth measurement login to view 9 more bullets countersink + insertion login to view 3 more bullets Plate fixation plate selection and fit login to view 8 more bullets provisional fixation through plate login to view 4 more bullets drilling and screw insertion through plate login to view 10 more bullets special scenario login to view 2 more bullets finalize fixation login to view 2 more bullets Surgery completion remove temporary fixation wires, instruments, and other non-implantable components prior to completion of surgery confirm positioning in 2 planes with fluoroscopy close per surgeon preference Technical specifications Plate families lateral anatomical fibular plate posterolateral tibial plates (type iia) posteromedial tibial plates (type iib) posterior tibial plates (type iii) medial plate straight plate login to view 1 more bullet Screw trajectory manufacturer-specified conical trajectory allowance through plate holes: ±15° Instrumentation overview provisional fixation login to view 1 more bullet drill guides login to view 1 more bullet depth instruments login to view 1 more bullet bending tools login to view 1 more bullet Screws Compatibility summary locking screws login to view 2 more bullets non-locking screws login to view 2 more bullets Diameters available Ø2.7 mm Ø3.5 mm Ø4.0 mm Drill bit size compatibility Ø2.7 mm screw login to view 2 more bullets Ø3.5 mm screw login to view 2 more bullets Ø4.0 mm screw login to view 2 more bullets note: the Ø2.7/Ø2.71 mm drill bit and drill guides are dual purpose (pilot for Ø4.0 screws; lag for Ø2.7 screws) Drill guide color-band convention pilot guides login to view 1 more bullet lag guides login to view 1 more bullet Key precautions do not exceed the stated conical trajectory range (especially when using a washer) do not read depth from the top of drill guides; use depth measurement instruments as instructed do not use countersink or screwdriver bits with powered instruments