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Unstable Weber B fracture

Syndesmotic instability in Weber B ankle fractures: a

Abstract Objective: Syndesmotic instability may coexist with unstable Weber B supination-external rotation (SE) lateral malleolar fractures. Current recommendations suggest that Weber B injuries should not have associated syndesmotic instability after open reduction and internal fixation of the lateral malleolus 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, specifically the distal tibiofibular syndesmosis. It has a role in determining treatment The inclusion criteria were all unstable Weber B ankle fractures in patients over 50, who were unsuitable for rigid internal fixation because of poor bone stock, poor skin condition on the lateral side over the fibula and swelling Stability of Weber B Fractures. - 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 Stable ankle fractures (such as the majority of Weber A and B fractures) have great prognosis and can be treated conservatively. Whereas other fracture patterns are inherently unstable, and are widely treated surgically (for example, Weber C fractures). Hence, defining the stability of ankle fracture is of utmost importance

Weber classification of ankle fractures Radiology

A new technique for fixing unstable Weber B fractures of

The anatomical classification of Weber [ 2] categorises fractures according to the site of the injury with type B being at the level of the syndesmosis and accounting for up to 50% of these injuries [ 3 ] Ankle Fracture - Weber B 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

Stability of Weber B Fractures : Wheeless' Textbook of

  1. In unstable ankle fractures, the ankle joint itself is displaced or can be displaced when it is subject to normal forces. Specifically, the lower bone of the ankle joint (the talus) is out of position or can be shifted out of position, leading to incongruity of the ankle joint
  2. Stable fractures, where the alignment of the ankle joint is preserved, rarely need surgery. Unstable fractures typically require closed reduction or open reduction and internal fixation, depending on the patient's co-morbidities and pre-injury functional status. There is an increasing trend toward operative management of unstable ankle fractures
  3. These fractures range from stable to unstable, and accordingly may be treated conservatively with immobilization or operatively with open reduction and internal fixation. Unstable Weber classification type B fibula fractures are at the level of the syndesmosis. When stressed, they show an increased medial clear space widening
  4. In some instances, the ankle joint will appear to be intact, but the joint will displace when it is stressed, demonstrating that the ankle fracture is actually unstable. Figure 1: Plain X-rays of a Stable Ankle Fracture. There are two common types of stable ankle fractures: Pulling Fractures of the Fibula (Avulsion or Weber A type fractures)
  5. Fractures of the Ankle and the Distal Part of the Tibia. Instability of the distal tibiofibular syndesmosis after bimalleolar and trimalleolar ankle fractures. The Dorsal Antiglide Plate in the Treatment of Danis-Weber Type-B Fractures of the Distal Fibula. Rush rods versus plate osteosyntheses for unstable ankle fractures in the elderly

When evaluating a Weber B fracture, if the initial imaging does not demonstrate obvious evidence of tibiotalar instability, ankle stress testing is indicated. There are three primary methods of performing an ankle stress test. These include manual, gravity, and weight-bearing techniques The generally accepted treatment of displaced or unstable Weber B ankle fractures involves surgical stabilization, because anatomical restoration of the lateral malleolus is important to avoid subluxation of the ankle joint and promote biomechanical recovery [3,4]. Nevertheless, controversy remains with regard to the optimal method of fixation The supination-external rotation or Weber B type fracture exists as a stable and an unstable type. The unstable type has a medial malleolus fracture or deltoid ligament lesion in addition to a fibular fracture. The consensus is the unstable type and best treated by open reduction and internal fixation

Any time a bone moves out of its normal position, it's called a displaced fracture. Highly displaced fractures are considered to be unstable. Surgery is typically required to get the broken parts.. Majority of isolated Weber B (transsyndemotic) Isolated undisplaced medial or posterior malleolar ; If Weber A or B fractures are part of a bi or trimalleolar fracture pattern, they are unstable. Unstable fractures. In general, features of an unstable fracture are: Multiple fractures; Fractures above the syndesmosis; Talar shift/til Ankle fracture is a common injury, with an annual incidence between 122 and 187 per 100 000 population.1-3 Seventy per cent of ankle fractures are unimalleolar injuries and the Weber B type fibula fracture is by far the most common type of ankle fracture.1 3-8 These fractures can be either stable or unstable depending on the accompanying sof The goal of this investigation was to determine if patient effort can influence medial clear space (MCS) measurements in proven unstable bimalleolar-equivalent ankle fractures. Methods: Patients presenting with Weber B fibula fractures were assessed for mortise stability using the GSV. If the GSV demonstrated instability based on MCS widening. 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. Design Randomised, pragmatic, non-inferiority, clinical trial with blinded outcome assessment. Setting Two major trauma centres in Finland, 22 December.

Introduction: The Emergency Department management of ankle fractures varies greatly between stable and unstable injuries. Unstable Fractures: Fractures that compromise the stability of the MORTISE (formed by the medial and posterior malleolae of the tibia, the lateral malleolus of the fibula and associated ligaments) are considered unstable. They often involve fractures to two or more of the. Lateral malleolar fracture types . Weber classification. Weber A fractures are inversion injuries and may be small avulsions or transverse fractures. Weber B fractures (very common) are spiral and are caused by External Rotation (ER) of the foot. Weber C fractures are less common ER injuries with disruption of the syndesmosis (diastasis) Unstable Weber B Ankle Fracture: 6 weeks out in a noncompliant patient with callous formation. Close. Vote. Posted by 5 minutes ago. Unstable Weber B Ankle Fracture: 6 weeks out in a noncompliant patient with callous formation. 1 comment. share. save. hide. report. 100% Upvoted. Log in or sign up to leave a comment Log In Sign Up. Sort by When assessed the relationship between the type of fracture according to the Weber classification and the risk of dislocation, osteochondral injury, and unstable syndesmotic injury, type A had the highest risk of osteochondral injury, followed by type C and finally type B fractures (60%, 34%, 16%, p = 0.02)

1. Introduction. Ankle fractures are the most commonly sustained fracture for patients between the ages of 20 and 65 with an incidence of almost 90 000 per year [].The anatomical classification of Weber [] categorises fractures according to the site of the injury with type B being at the level of the syndesmosis and accounting for up to 50% of these injuries [] A Weber B fracture is an oblique lateral malleolus fracture at the level of the talar dome. While Weber B fractures associated with any suspicion for medial or deltoid ligament injury should be made non-weight bearing in a back slab, there are two ED management options for isolated Weber B fractures without any suspicion for medial involvement

Fractures that are in a poor position, that are 'unstable' or likely to move may be treated with surgery. If the break heals in a poor position, this can lead to a loss of function or movement, ongoing pain in the ankle, or development of arthritis. This is why surgery may be recommended. Treatment of Ankle Fractures the fracture is healed, progressive ROM and open and closed kinetic chain exercises are initiated. Classification System . 1. Weber/AO - categorizes fractures on level of the fibular fracture. a. Type A - Fractures below the tibial plafond and typically transverse. b

Diabetic Ankle Fractures . Answer- NO - Unstable ankle fractures in diabetics are still best treated with anatomic restoration of the ankle mortise and stable internal fixation, but - Because the soft tissue complications are higher, increased care must be given to atraumatic soft tissue techniques (limb at level of heart, careful of S Weber B fracture (v1) This information will guide you through the next 6 weeks of your rehabilitation. Use the video or information below to gain a better understanding of your injury and what can be done to maximise your recovery. Healing: This normally takes approximately 6 weeks to heal

The doctors examined all patients with potential unstable SER2 fractures who underwent a weight bearing CT exam over a span 0f 10 months. None of the patients had a widening of the medial clear space significantly different from what was measured on weight bearing X-Rau. However, WBCT did uncover additional clinical findings in 40% of patients The images show a Weber B fracture. The oblique course of the fracture is typical for Weber B and results from the exorotation of the talus that pushes against the fixed lateral malleolus. The malleolar fracture usually starts medially at the level of the talar dome, but can also start a few centimeters above this level Unstable Fracture Healing Time and Recovery Time: It requires more than 8 weeks. Prevention of Unstable Bone Injury. The Weber A, B, C fracture fracture evaluation would be done easily then. In the case of other types of fracture such as Salter Harris fracture, there are different types of fractures that happen on the growth plate of kids.. Syndesmotic instability is common after bony fixation in unstable Weber B, SE type ankle fractures and must be sought out and treated. * If noted, the author indicates something of value received. The codes are identified as a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options and e-consultant or employee

Weber B fracture Radiology Case Radiopaedia

Van Schie-Van der Weert EM, Van Lieshout EMM, De Vries MR, Van der Elst M, Schepers T. Determinants of outcome in operatively and non-operatively treated Weber-B ankle fractures. Arch Orthop Trauma Surg. 2012; 132(2): 257-63. doi: 10.1007/s00402-011-1397-z; Hancock MJ, Herbert RD, Stewart M. Prediction of outcome after ankle fracture General Ankle Fracture. Determined by stability of fracture: Stable, nondisplaced, isolated malleolar fracture: Splint or cast, early wt bearing, RICE; Unstable or displaced fracture: Requires ORIF, ortho consult, reduce and splint; Isolated lateral malleolar fracture. If stable (see Weber classification) treat like severe Ankle Sprai On the left image a Weber A or SA-fracture. This ankle is stable because there is only an avulsion fracture of the lateral malleolus below the level of the syndesmosis. The ring is broken in only one place. On the right image there is an unstable fracture. The ring of the ankle is broken in two places Acute unstable Weber B fracture (unimalleolar, bimalleolar or trimalleolar fractures). Operable with both methods of surgery within 3 weeks after injury. Men and women ≥ 60 yoa. Exclusion Criteria: Prior injury or pathology with reduced ankle function. Other acute foot/ankle/leg injury that will affect ankle function

Later, the fracture was identified as a Weber B distal fibular fracture by stress-view radiography. This case reviews the evaluation of acute ankle injuries in the ED and the utility of POCUS as a supplemental imaging modality in the evaluation of ankle fracture. a Type B fracture is unstable. 9 Ankle stability is commonly determined using. The Acumed Fibula Rod System offers an alternative approach to traditional fibular plating by providing fracture stability with a minimally invasive surgical technique. In this video, Dr. Younger demonstrates using the Fibula Rod to reduce and provide fixation to an unstable Weber B fracture

Many Type B fractures require operative management (but not all) and type C fractures tend to all require operative management. Non-operative Stable, non-displaced, isolated uni-malleolar fracture (without opposing ligament injury), can be splinted in short leg splint or boot (with ankle at 90 degrees) with early weight bearing as tolerated. 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 The aims of this study were to present a remedy for isolated Weber type B fractures using a new surgical technique, a specialized anatomical locking plate without inter-fragmentary lag screws, and an early weight-bearing protocol after surgery, a - Presumably, most Weber B fractures, involving rupture of the anterior inferior tibiofibular ligament and a spiral or oblique fracture of the fibula, are stable and generally do well with 6 weeks of immobilization and limited weight bearing; it is this subset of potentially unstable fractures whose management is a matter o

The Radiology Assistant : Ankle fracture - Weber and Lauge

Stable Weber B fractures do not necessarily require follow-up radiography, 17 although it has been argued that Weber B fractures have the potential to become unstable and that they should be re-imaged at 2 weeks to assess for proper alignment before mature callous sets in. 16 If there is continued appropriate alignment at the 2 week mark, then. The Danis-Weber classification is a method of describing ankle fractures. It has three categories, based primarily upon the fracture of the fibula: Type A. Fracture of the fibula distal to syndesmosis. An oblique medial malleolus fracture may also be present. Type B. Fracture of the fibula at the level of the syndesmosis Patients presenting with Weber B fibula fractures were assessed for mortise stability using the GSV. If the GSV demonstrated instability based on MCS widening >4 mm, 3 additional views were performed: GSV with an assistant maintaining the ankle in a neutral position; GSV with the patient actively dorsiflexing to neutral; and GSV with the patient actively dorsiflexing and supinating the foot WEBER CLASSIFICATION. Weber A fractures are inversion injuries and may be small avulsions or transverse fractures.. Weber B fractures (very common) are spiral and are caused by External Rotation (ER) of the foot.. Weber C fractures are less common ER injuries with disruption of the syndesmosis (diastasis).. Lateral malleolar fractures (undisplaced) Adults with a stable fracture of their.

2. Closed Unstable Supination Eversion type Weber B fibula fracture 3. Soft tissue amenable to operative treatment 4. Opt for surgical treatment of their fracture 5. Willing to follow up for 1 year 6. Consent to be randomized [return to top] Exclusion Criteria. 1. Aged < 18 or over 85 2. Open fracture 3. Prisoners 4. Unlikely to followup 5. Non. unstable Weber type B or C fractures in 24 adult patients with type 1 or type 2 diabetes. The re-operation rate for wound dehiscence or other indications such as amputation, mortality, and functional outcomes was determined. Results Two patients developed lateral side wound infection, one of whom underwent wound debridement. Three other patient The treatment will be based on fracture alignment and stability of the ankle. There are some additional, unique types of fractures. Maisonneuve fracture. A Maisonneuve fracture, for example, involves a complete disruption of the ligaments around the ankle associated with a fracture of the fibula at the level of the knee

Weber A fracture. Characteristics of Weber B: Fibular fracture at the level of the syndesmosis (fig. 18). Tibiofibular syndesmosis is intact/partial rupture. NO widening of the tibiofibular joint. Stable/unstable This study reviewed 94 cases of ankle fractures treated with operative methods. Results. There were 52 cases of Weber type B lateral malleolar fractures and 13 cases of Wagstaffe fractures combined with them (25%). Ankle diastases were diagnosed in 20 cases (38.5%) in all Weber type B fractures and 11 (84.6%) of the 13 Wagstaffe fractures Summary. Ankle fractures are the most common fractures of the lower extremity. They are most often caused by twisting the ankle, the circumstances of which the patient will typically recall. The major symptoms are pain in the affected area and decreased range of motion.If physical examination and the patient history suggest a fracture (e.g., patient is unable to bear weight on the affected leg.

Stable or unstable Weber B : AskDocs - reddi

The Radiology Assistant : Weber and Lauge-Hansen

Maisonneuve fracture. A Maisonneuve fracture describes a fracture of the proximal fibula combined with an unstable ankle injury.. Sometimes considered a high Weber C, should not be missed! On occasion the energy from an ankle injury will pass through the ankle and syndesmosis and exit at the proximal fibula Ankle Injury Management (AIM): design of a pragmatic multi-centre equivalence randomised controlled trial comparing Close Contact Casting (CCC) to Open surgical Reduction and Internal Fixation (ORIF) in the treatment of unstable ankle fractures in patients over 60 year

Musculoskeletal case studies for medical studentsAnkle fractures | Consultant Medical

Ankle Fractures - Trauma - Orthobullet

Strauss et al retrospectively reviewed 279 charts for severity of injury, postoperative complications, and functional outcome after surgical fixation of an unstable ankle fracture. 21 They found that obese patients had more comorbidities and a higher incidence of Weber type B and C ankle fractures than nonobese patients. 21 However, there was. 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. Please see the picture below to understand where. outcomes in surgically treated unstable ankle fractures. Material and methods: This prospective cohort study was conducted on 68 patients who underwent surgical management for an unstable ankle injury. Demographic Weber-B, followed by Weber-A 15(27%) and Weber-C 13(24%) cases. There were 13 patients (19%) wit unstable fractures Higher risk Of complications More technically difficult to apply Sp/int/casr Construction Unstable ORIF required Weber B Fracture at level of syndesmosis Syndesmosis intact or partially torn Possible medial fracture or deltoid damage Stability variabl In some instances, the ankle joint will appear to be intact, but the joint will displace when it is stressed, demonstrating that the ankle fracture is actually unstable. There are two common types of stable ankle fractures: Pulling Fractures of the Fibula (Avulsion or Weber A type fractures). These injuries are equivalent to a severe ankle sprain

Danis-Weber classification - Wikipedi

Unstable type II and III injuries occurred in 52 patients, accounting for 45% of all cases, but occurred in 32% of Weber B fractures compared to 70% of Weber C fractures (Table 3). Position of the fibular fracture is significantly related to the degree of syndesmotic stability (χ 2 = 15.50, P = 0.0014) unstable injuries [3]. There are two other commonly used classifications systems: (1) Danis-Weber AO Classification It was introduced by Danis in 1949, modified by Weber in 1966 then adopted by the AO group. Three types are recognized based largely upon the level of the fibula fracture and the associated level of syn-desmosis disruption (Figure 3) In contrast, when injury occurs above the syndesmosis, these Weber C fractures tend to be unstable and require surgery. In between is a clinical gray area: Weber B fractures at the level of.

Optimal management of ankle syndesmosis injurie

Pearl: Management of Weber B fractures is institution dependent. Some institutions recommend a stress view. If normal, patients can be made weight-bearing as tolerated. Pearl: Bi or Tri fractures (ie. two or three malleoli fractures are identified) are always unstable Weber A fractures or Weber B fractures without talar shift; Those unfit for surgical intervention; Surgical Management. Open reduction and internal fixation (ORIF) is often required in ankle fractures to achieve stable anatomical reduction of the talus within the ankle mortise Doctors classify ankle fractures according to the area of bone that is broken. For example, a fracture at the end of the fibula is called a lateral malleolus fracture, or if both the tibia and fibula are broken, it is called a bimalleolar fracture. Two joints are involved in ankle fractures: Ankle joint - where the tibia, fibula, and talus meet A fracture is also known as a bone break. There are various types of these at the ankle depending on where and which bones are involved. The most common part to be affected is the outside of your leg on the fibula bone and these fractures are referred to as Weber A, B or C depending on where the fracture is. Weber A = below the ankle joint and. Weber B: Weber b is a category of ankle fracture where the fracture line is at or near the level of the plafond (tibia joint space). It can be oblique, spiral, or transverse. 5.1k views Reviewed >2 years ago. Thank. Dr. David Hettinger agrees

Operative Versus Non Operative Treatment for Unstable

Ankle fracture - WikEMLAUGE HANSEN CLASSIFICATION PDFFoot and Ankle Trauma | Musculoskeletal Key

ankle fracture and unstable syndesmosis resulted in a low malreduction rate and both methods maintained reduction well. 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. A syndesmosis injury in SER ankle fractures A Weber type B fracture may be an isolated fibular fracture or a fracture of the lateral malleolus combined with a fracture of the medial malleolus (a so-called bimalleolar fracture) or a Volkmann. Inclusion criterions: (i) Unstable fracture (Denis-Weber A, B) which met the indications of ORIF: displacement (or shortening) of the fibula more than 2 mm; (ii) Comminuted fractures (Denis-Weber A, B). The exclusion criteria were: (i) Type C Weber fractures; (ii) simple lateral malleolar fracture including linear and transverse/oblique fracture Proper classification of the fracture will also help the doctor analyze the stability of the fracture injury and the extent of the damage. For better understanding, the Weber classification of ankle fractures will be combined with the Lauge-Hansen system. The Weber A, B, C fracture fracture evaluation would be done easily then