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In this study, an improved finite element model is applied to compare the biomechanical stability of plates with three different options in the treatment of distal fibula fractures. A CT scan of the knee to ankle segment of a volunteer was performed. A three-dimensional finite element model of the fibula was reconstructed based on the CT data. Three different loads (uni-pedal standing, torsion, and twisting) were applied, the same as in the experiments in the literature. The stresses and strains of the three options were compared under the same loads, using a 4-hole locking plate (Option A), a 5-hole locking plate (Option B), and a 6-hole locking plate (Option C) in a standard plate for lateral internal fixation. The simulation results show that all three options showed a stress masking effect. Option C had the best overall biomechanical performance and could effectively distribute the transferred weight. This is because option C has greater torsional stiffness and better biomechanical stability than options A and B, and therefore, option C is the recommended internal fixation method for distal fibula fractures. The finite element analysis method developed in this work is applicable to the stress analysis of fracture treatment options in other body parts.

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