Ankle fracture weber b ankle 3 east sussex healthcare. Objective this study aimed to determine if surgery is superior to nonsurgical management for the treatment of these fractures. The secondary aim was to gain insight in various factors influencing outcome. B involves a spiral fibula fracture beginning at the level of the joint and a. Mathes ankle fractures breaks are very common injuries that usually happen from a fall where the ankle is twisted or rolled or there is high. The gray area of treatment lies mainly with the minimally displaced weber b type ankle fractures. This fracture can exist as isolated fractures of the lateral malleolus, or bimalleolar injuries in which both lateral and medial malleoli are fractured. Ankle fractures acta chirurgiae orthopaedicae et traumatologiae. It takes into consideration the position of the distal fibular fracture in relation to the syndesmosis of the ankle joint. Many type b fractures require operative management but not all and type c fractures tend to all require operative management. Pdf ankle fracture is one of the most common lower limb fractures for they. Ankle fractures are increasingly common injuries that necessitate a careful approach for proper management. Over five million ankle injuries occur each year in the united states alone. Anteroposterior a and lateral b xrays demonstrating weber b fracture of the ankle.
The mullerao classification danisweber is based on the fracture location of. The most controversial ankle fracture is the weber b fracture in which the fibular or lateral malleolar fracture begins at the level of the ankle mortise and extends proximal and lateral. The primary aim of this study was to determine the outcome of operatively and conservatively treated patients with an ao weber b type ankle fracture. In isolated stable weberb type ankle fractures, immobilization for 3 weeks with a cast or orthosis was noninferior to cast immobilization for 6 weeks for outcomes at 1 year van dijk, c. This should optimise functional recovery and reduce the chance of development of posttraumatic arthritis. Twenty five patients with operated weber a b c fractures. It is unclear whether these fractures should be managed surgically or not.
Operative versus non operative treatment for unstable. Lateral malleolar fractures occurring at the level of the ankle. So do we change the indications and goals of treatment. Rehabilitation for ankle fractures in adults ankle fracture is one of the most common fractures of the lower limb, especially in older women and young men. Reproducibility of the laugehansen, danis weber, and ao classifications for ankle fractures. Tibiofibular clear space of 6 mm or more on anteroposterior radiography. Ankle fracture is a common injury, with an annual incidence between 122 and 187 per 100 000 population. Compression stocking to be worn to control swelling along with iceelevation. Pdf determinants of outcome in operatively and nonoperatively. It is generally treated surgically or nonsurgically, followed by a period of immobilisation to prevent complications such as malunion. The weber classification describes ankle fractures according to their location. Ankle is a three bone joint composed of the tibia, fibula an talus talus articulates with the tibial plafond superiorly, posterior malleolus of the tibia posteriorly and medial malleolus medially lateral articulation is with malleolus of fibula. Immediate unprotected weightbearing of operatively. There is still the possibility of a weber c fracture stage 4, i.
Patient information physiotherapy following an ankle fracture. Primary ankle arthrodesis for neglected open weber b ankle fracture dislocation. A retrospective cohort study in patients with a aoweber btype ankle fracture. It was introduced by danis in 1949, modified by weber in 1966 then.
In conclusion, stable weber b type fibula fractures can safely be treated with only three weeks of cast immobilization or even with a simple orthosis. Determinants of outcome in operatively and nonoperatively. Three week versus six week immobilisation for stable weber. A 1 mm lateral shift of the talus decreases the contact area by 42%, which would be highly unstable14. The danis weber classification1 weber classification is a simple method for classifying fractures of lateral ankle fractures and is based on radiographic criteria. Manual stress requires time and more radiation exposure. Pdf treatment of ankle fractures is often based on fracture type and surgeons. Mri had a sensitivity of 100% and specificity of 93% for diagnosis of aitfl rupture, using ankle arthroscopy as the benchmark. Katherine thomason, ashwanth ramesh, niall mcgoldrick, richard cove, james c. The weber ankle fracture classification or danis weber classification is a simple system for classification of lateral malleolar fractures, relating to the level of the fracture in relation to the ankle joint. Fractures of the ankle joint are among the commonest fractures in adults, with an incidence of up to 174 cases per 100 000 persons per year. Conclusion isolated transsyndesmotic weber b ankle fractures, that are clinically and radiologically stable, can be safely treated with functional bracing.
This is classified as a stable weber b type fracture. Shared care plan eastbourne 023 414928 conquest 01424 757576 email esht. State the indication to fix posterior malleolar fractures. Three week versus six week immobilisation for stable weber b type. For a good longterm functional outcome to be achieved, reliable early evaluation is crucial so that it can be determined whether the problem is a distorsion sprain, ligament rupture, bony ligament avulsion, or fracture of the. Come out of the boot and begin to move your ankle up and down immediately after surgery so your ankle does not get stiff.
The improved smallfragment implants and instruments, anatomic plates, and locking screw technology allow the effective treatment of the majority of ankle fracture patterns. Ankle fracture weber b east sussex healthcare nhs trust. The aim of treatment is to restore and maintain stability and alignment of the joint, ideally with normal anatomy of the ankle mortise. In weber c fractures the syndesmosis is stabiles ed by a syndesmosis screw between the plate on the lateral side and the outer cortex of the fibula. An analysis of the national trauma data bank 2007 to 2011. The ankle fracture management system was developed to be the most comprehensive set available for the treatment of common ankle fracture injuries.
This normally takes approximately 6 weeks to unite heal although pain and swelling can be ongoing for 36 months. Use the video or information below to gain a better understanding of your injury and what can be done to maximise your recovery. You have sustained a fracture to your fibula outside ankle bone. Weber b type ankle fractures with a cast or a simple orthotic device for. Clinical utility of a stabilitybased ankle fracture classification system. Weber b describes ankle fractures at the syndesmosis. Note the bimalleolar pattern with transverse fracture of the medial malleolus and oblique fracture of fibula beginning at the mortise. Victoria bc v8z 0b9 tel 250 940 4444 fax 250 385 9600 page 1 april 2015 v1s. Introduction ankle fractures are one of the most common lower limb fractures 1.
This patients fracture pattern fulfils all of the criteria for operative management. Rehabilitation for ankle fractures in adults cochrane. There are three classifications based on the location and type of fracture. Diabetes mellitus is a common medical condition that is increasing in prevalence both closed and open management of ankle fractures in diabetics have higher complication rates solution. Ankle fractures lateral malleolar fractures when to refer acutely displaced weber b fractures all weber c fractures bimalleolar fractures delayed persistent pain avhap educational talk 28 june 2011, duy thai. Pdf standardised virtual fracture clinic management of. Fracture of the lateral malleolus distal to the syndesmosis the connection between the distal ends of the tibia and fibula. Ankle fractures are common and the majority are the result of low energy torsional trauma. Standardised virtual fracture clinic management of radiographically stable weber b ankle fractures is safe, cost effective and reproducible article pdf available in. Surgical vs nonsurgical management of weber b fractures. Background isolated type b ankle fractures with no injury to the medial side are the most common type of ankle fracture. Methods a pragmatic, multicentre, singleblinded, combined randomised controlled trial and observational study. Reexamination on the ankle films there was no sign of an oblique fracture of the lateral malleolus, so we can exclude a weber b fracture.