Ankle fracture weber b east sussex healthcare nhs trust. Weber classification of ankle fractures radiology reference. The danis weber classification1 weber classification is a simple method for classifying fractures of lateral ankle fractures and is based on radiographic criteria. Surgical vs nonsurgical management of weber b fractures. Classification the fracture is classified according to weber as a type b fracture.
Fracture management overview history who, what, when, where, why o who age, job, hobbies, hand dominance if hand involved, cognition amts score if elderly o what happened and exactly how it happened mechanism of injury force involved likelihood of other structure damage o when it happened o where it happened o why. Setting two major trauma centres in finland, 22 december. Determinants of outcome in operatively and nonoperatively treated weber b ankle fractures. It was described by danis and subsequently weber,5 6 and it is based on the fibular fracture in relation to the syndesmosis on radiography fig 4. Reduce if displaced may be by open reduction, closed manipulation, or traction 3. Fracture of the lateral malleolus distal to the syndesmosis the connection between the distal ends of the tibia and fibula.
A high fibula fracture near the fibular neck is known as a maisonneuve fracture. Methods a pragmatic, multicentre, singleblinded, combined randomised controlled trial and observational study. Background isolated type b ankle fractures with no injury to the medial side are the most common type of ankle fracture. 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 talocrural joint. Jan 23, 2019 objective to determine whether treatment of isolated stable weber b type ankle fractures with a cast or a simple orthotic device for three weeks produces noninferior outcomes compared with conventional immobilisation in a cast for six weeks. Use the video or information below to gain a better understanding of your injury and what can be done to maximise your recovery. There are similar fracture rates overall between women and men, but men have a higher rate as young adults, while women have higher rates in the 50 to 70year age group. There are many different types of fractures of the ankle. Oct 28, 2011 the danisweber classification for ankle fractures is simple and the most useful for primary care management. There are many types of ankle fractures, and treatments vary significantly depending on the location and severity of the injury. Functional outcomes following operative and nonoperative.
The nonoperative treatment of weber b type ankle fractures and. Ankle fracture is one of the most common lower limb fractures for they account for 9% of all fractures representing a significant portion of the trauma workload. Design randomised, pragmatic, noninferiority, clinical trial with blinded outcome assessment. Huang et al did not find any significant difference in functional outcomes between patients operatively treated using onethird tubular plates, lcps, and lcp distal fibula plates for the fixation of distal fibular fractures. Virtual fracture clinic in the management of foot and ankle. What is the most appropriate definitive management option of figures b through f. This unfocused system means that while on one hand minor injuries are being over investigated. Indications for operative treatment of ankle fractures are dictated by the stability of the ankle joint. Although the knowledge of the natural history and management of these injuries have improved, this system of fracture management is still being adopted. Please see the picture below to understand where this injury is. In treating a fracture, the objectives of the treatment are as follows. Fracture type radiographic evaluation acute treatment definitive treatment follow. There are subtle findings which indicate a fracture of the posterior malleolus.
Both closed and open management of ankle fractures. Lateral malleolar fracture displaced weber b weber c bimalleolar avhap educational talk 28 june 2011, duy thai. Understanding risks and complications in the management of. There is a higher rate of complication following surgical management, including infection, reoperation, thromboembolic events and death. This is a followup leaflet to your recent telephone consultation with the fracture care team explaining the ongoing management of your injury. Literature on open fracture classification interobserver agreement poor range 4294% for each fracture least experienced59% agreement orthopaedic trauma fellowship trained66% agreement. Three week versus six week immobilisation for stable weber b. Manual stress requires time and more radiation exposure. A fracture is an interruption of the continuity of bone, this page will discuss ankle and foot fractures and the role that physiotherapists play in the rehabiliation of such injuries. The aim of treatment is to restore and maintain stability and alignment of the joint, ideally with normal anatomy of the ankle mortise. Ankle fractures posterolateral approach 4192016 34 maissoneuve fracture. Two commonly used classification systems for ankle fractures include the danis weber ao. Weber classification of ankle fractures dr jeremy jones and assoc prof frank gaillard et al.
Management of isolated lateral malleolar fracture new page 2. Principles in fractures management linkedin slideshare. It takes into consideration the position of the distal fibular fracture in relation to the syndesmosis of the ankle joint. For a simple fracture, where there are only two bone fragments, this is apparent. Objective this study aimed to determine if surgery is superior to nonsurgical management for the treatment of these fractures. It is generally thought that bi and trimalleolar fractures are unstable, as are pronation external rotation injuries resulting in an isolated high fibular fracture weber typec, where the. Clinical utility of a stabilitybased ankle fracture classification system. Pdf ankle fracture is one of the most common lower limb fractures for they account for 9% of all fractures representing a significant portion of the. Diagnosis ankle fractures usually result from torsional forces and present typically with tenderness, swelling, deformity and inability to weightbear. Lateral malleolus fractures nonoperative management 23 mm displacement no medial widening or syndesmotic injury cast or boot. To assign each fracture to a segment, the center of the fracture must be determined.
When an ankle fracture has been diagnosed, the choice of treatment. According to lauge hansen the oblique fibular fracture indicates that this is a supination exorotation injury stage 2 or higher. Bmi of 38, established peripheral neuropathy, and his most recent hba1c is 8. Fortunately, your fracture is minor and does not require an operation or plaster cast to treat it successfully. It is the midpoint of an oblique or spiral fracture, and in a transverse fracture it is obvious. This is classified as a stable weber b type fracture. Ankle fractures lecture orthopaedic trauma association. Classification type a below level of the ankle joint tibiofibular syndesmosis intact deltoid ligament intact medial malleolus often fractured usually stable, although occasionally requires open reduction and internal fixation orif type b at the level of. Management fracture management stages include 4 rs. Transverse fracture or rupture of the deltoid ligament posterior malleolus posterior syndesmosis ruptured an avulsion of the posterior malleolus. The commonly used weber classification relies solely on the level of the lateral malleolar fracture relative to the ankle joint line. Shared care plan eastbourne 023 414928 conquest 01424 757576 email esht.
May 23, 2014 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. A weber a is a simple fracture to the bottom part of the fibula bone on the outer part of your leg. Fractures of the ankle joint are common amongst adults. Surgical management for olecranon fractures in adults. Cigarette smoking and a high body mass index have been associated with ankle fractures 5,6. This normally takes approximately 6 weeks to unite heal although pain and swelling can be ongoing for 36 months. He was immediately hit anteriorly and had a twisting and hyperextension injury to his knee with severe pain. Musculoskeletal s tructures and f unction the s keletal s tructures modern orthopaedics is concerned with the diagnosis and management of disorders of the musculoskeletal system, that is the skeleton and. 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. Danisweber classification of ankle fractures physiopedia.
Weber a fracture this information will guide you through the next 6 weeks of your rehabilitation. Stabilitybased classification for ankle fracture management and the. However, beware the nondisplaced ankle fracture presenting postinjury with minimal swelling and no deformity. You have sustained a fracture to your fibula outside ankle bone. This should optimise functional recovery and reduce the chance of development of posttraumatic arthritis. Always examine the ankle when you see a spiral fracture. Basic principles of fracture management slideshare. Retain to maintain position while healing occurs by internal fixation, external fixation, or conservative methods. Ankle fractures are common and the majority are the result of low energy torsional trauma. Management is determined by the location of the fracture.
Sep 24, 20 basic principles of fracture management 1. Fractures and dislocations university of cincinnati. Jun 21, 2019 there were no significant differences identified between surgical and nonsurgical management of weber b fractures with respect to functional outcome. Weber a fractures stable camwalker crutches for 6 weeks weight bear as tolerated in camwalker camwalker can be taken off when not weightbeating xray at 6 weeks clinical union no pain at fracture. Diabetic ankle fractures with or without neuropathy risks.
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