While not always necessary, surgery for ankle fractures can be done with 3 kinds of metal plate and multiple screws: one-third tubular plate; locking compression (LCP) metaphyseal plate for lateral malleolar fracture and Weber B fracture; LCP distal fibula plate Weber A fracture and Weber B fracture. Type B – Fractures at level of tibial plafond and typically extend proximally in a spiral or short oblique fashion. N2 - Although the treatment of ankle fractures is often straightforward, several controversies remain. fractures. relatively low, Weber type C fracture pattern. Dr. Edward Hellman answered. 0. Patients/Participants:Over a 7-year period, 238 skeletally mature patients with unstable SE pattern Weber B … Type B â Fractures at level of tibial plafond and typically extend proximally in a spiral or short oblique fashion. Stability in ankle fractures: Diagnosis and treatment EFORT Open Rev. The fracture may be treated with a short leg cast or a removable brace. The Weber classification is used to class lateral malleolar fractures, based on the location of the fibular fracture - below, at the level of or above the distal tibiofibular joint. You have sustained a fracture to your fibula (outside ankle bone). If the Orthopaedic Consultant considers this unstable, an operation with plate and screws may be required. Sometimes a Plaster is used. If your injury is classified as a stable Weber B type fracture, you will be treated in a boot. 4,262,263 Survival is better in primary than in secondary VF. Foot Ankle Int. The weber classification of ankle fractures classifies based on the location of the fracture (break) with respect to the syndesmosis (connection between tibia and fibula just above the ankle joint. Kortekangas T, Haapasalo H, Flinkkilä T, et al. b. There are three classifications based on the location and type of fracture. Department of Orthopaedic Surgery, Union Memorial Hospital, Baltimore, Maryland, USA. Abdominal aortic calcification or âAACâ is a stable marker of CVD that can be semi-quantified using images for vertebral fracture assessment. Treatment. All patients with stable Weber A or B ankle fractures seen between 1st June 2005 and 4th June 2013 were included. The Danis-Weber classification (also known as the Weber classification) is another common method of describing ankle fractures. Non-inferiority trials are designed to show that an alternative treatment (shorter cast length or orth-osis, in this case) is not worse than the control (6-week cast) by a predetermined margin (OMAS score difference of 8.8 points, in this case). type is the Weber B type fibula fracture with 65.8%. 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 non-inferior outcomes compared with conventional immobilisation in a cast for six weeks. T1 - Controversies in ankle fracture treatment. WAWA (webril, ace, webril, ace) Know the wound classifications. If your injury is classified as a stable Weber B type fracture, you will be treated in a boot. 2.Define the specific articular pathology associated with SA and PAB fractures. Weber A fractures occur distal to the joint line, while Weber B fractures involve the joint line and finally, Weber C fractures are confined above the joint line. There are three classifications based on the location and type of fracture. Stage 1 - Rupture of the anterior syndesmosis; Stage 2 - Oblique fracture of the fibula (this is the true Weber B fracture) Treatment depends on whether the VT is monomorphic or polymorphic and whether left ventricular (LV) function is normal or impaired (eg, reduced LV ejection fraction [LVEF], heart failure). Nonsurgical Treatment. - ref: Comparison of two conservative methods of treating an isolated fracture of the lateral malleolus. Based on the position of the fibular fracture. - Discussion: - key to stability of ankle mortise is posterior syndesmotic ligament complex, ligament or posterior tibial tubercle or malleolus; - presence of a posterior lesion always indicates degree of instability, whether or not the medial structures are disrupted; - no matter what mechanism, instability must be assumed when injury to both sides of joint is accompanied by posterior … These are stable and can be treated with casting. From the pictures you’ve uploaded, it classifies as stable. Sometimes a Plaster is used. The Wagstaffe fracture can be a good diagnostic clue of ankle diastasis in Weber type B lateral malleolar fracture. fixation usually not required when fibula fracture within 4.5 cm of plafond. Historical treatment for stable Weber B fractures has included 6 weeks of cast immobilization, which produces high rates of bony union. 7.1 Healing Time. 60% of ankle fractures involve only the lateral malleolus.1 Fractures of the lateral malleolus proximal to the joint line correspond to syndesmotic injuries. However, for grossly displaced fractures it is often beneficial for the ankle joint to be repositioned (reduced) before the x-rays are taken. There are 3 bones that makes up the ankle joint and the lateral malleolus is the … 29 years experience Orthopedic Surgery. a. While this remains a safe option for fracture healing, associated negative consequences include patient inconvenience, stiffness, skin damage, and deep vein thrombosis. ankle fracture and unstable syndesmosis resulted in a low malreduction rate and both methods maintained reduction well. The management of Weber B ankle fractures remains dependent on fracture stability. A stable fracture is … N2 - Background The purpose of this study was to determine the incidence, relationship with the ankle diastasis, and effect of treatment of the anterior tibiofibular ligament avulsion fracture (Wagstaffe fracture) combined with the Weber type B lateral malleolar fracture. 6 In adults, the probability of survival declines by 7% to 10% for each minute of arrest without CPR and defibrillation. Sometimes a Plaster is used. Kortekangas T, et al. There are three grades which are based on their radiological appearance. 2. posterior ankle splint. Stable ankle fractures (such as the majority of Weber A and B fractures) have great prognosis and can be treated conservatively. Weber A fractures are fractures of the fibula below the level of the syndesmosis and generally represent stable ankle fractures. X-rays determine whether an ankle fracture is present and help determine if the injury is stable or unstable. The Danis-Weber classification[1] (Weber classification) is a simple method for classifying fractures of lateral ankle fractures and is based on radiographic criteria. 8 Type B fractures may be associated with a stable ankle joint. This information will guide you through the next 6 weeks of your rehabilitation. In general, features of an unstable fracture are: Multiple fractures CONCLUSION: The Wagstaffe fracture can be a good diagnostic clue of ankle diastasis in Weber type B lateral malleolar fracture. A Maison-neuve fracture occurs relatively proximally in the fibula and, therefore, tends to be fairly stable compared with a lower Weber type C fracture. The accurate reduction and fixation of the avulsed fragment is important for restoration of the stable distal tibiofibular joint and to prevent the chronic ankle joint pain caused by impingement of the avulsed fragment. Stage 1 - Rupture of the anterior syndesmosis; Stage 2 - Oblique fracture of the fibula (this is the true Weber B fracture) Weber A fracture. 7 Lateral Malleolus Fracture Treatment. Varies : Isolated fibula fractures typically heal over about 6-8 weeks. Tibia fractures are a common injury following trauma [2] and are susceptible to becoming an open fracture where the bone penetrates through the skin [3,4]. Methodology: 4/5 Usefulness: 3.5/5. The Wagstaffe fracture can be a good diagnostic clue of ankle diastasis in Weber type B lateral malleolar fracture. A syndesmosis injury in SER ankle fractures Please see the picture below to understand where this injury is. The Weber classification indicates the stability of the fracture, and is used to guide treatment. 21 23-26 Awareness of These are also called Lauge-Hansen supination-external rotation stage 2 fractures (8). Weber Classification. More stable injuries are often managed conservatively with close contact casts or braces and more unstable injuries are treated surgically, using open reduction and internal fixation (ORIF) using various methods, including plates and screws or tightrope [ 9 ]. 2018 May 21;3(5):294-303. doi: 10.1302/2058-5241.3.170057 . Over the last 15 years in practice, I have progressed in my treatment of stable unimalleolar Weber B ankle fractures from 6 weeks of non-weight-bearing with a cast to a protocol of 3 weeks of partial weight-bearing with a below-the-knee fracture boot and crutch gait assistance with transition at 3 weeks to full weight-bearing with the use of the fracture boot for a total of 6 weeks of immobilization. A stress x-ray may be done to see if the fracture and ankle are stable. Patients with possible unstable injury (Danis-Weber classification types B or C) or those with bimalleolar fractures should be referred to an orthopedist.
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