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 mullerao classification danisweber is based on the fracture location of. Use the video or information below to gain a better understanding of your injury and what can be done to maximise your recovery. Anteroposterior a and lateral b xrays demonstrating weber b fracture of the ankle. Ankle fractures acta chirurgiae orthopaedicae et traumatologiae. The danis weber classification1 weber classification is a simple method for classifying fractures of lateral ankle fractures and is based on radiographic criteria. Ankle fracture is a common injury, with an annual incidence between 122 and 187 per 100 000 population.
This should optimise functional recovery and reduce the chance of development of posttraumatic arthritis. Operative versus non operative treatment for unstable. Weber b describes ankle fractures at the syndesmosis. There is still the possibility of a weber c fracture stage 4, i. Fracture of the lateral malleolus distal to the syndesmosis the connection between the distal ends of the tibia and fibula. Ankle fractures are increasingly common injuries that necessitate a careful approach for proper management. It is unclear whether these fractures should be managed surgically or not. Katherine thomason, ashwanth ramesh, niall mcgoldrick, richard cove, james c.
Weber b fracture v1 this information will guide you through the next 6 weeks of your rehabilitation. Pdf determinants of outcome in operatively and nonoperatively. The ankle fracture management system was developed to be the most comprehensive set available for the treatment of common ankle fracture injuries. The commonly used weber classification relies solely on the level of the lateral malleolar fracture relative to the ankle joint line. So do we change the indications and goals of treatment. An analysis of the national trauma data bank 2007 to 2011.
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. Compression stocking to be worn to control swelling along with iceelevation. Ankle fracture weber b east sussex healthcare nhs trust. Occasionally the tibia the thicker bone in your lower leg may also be involved. Patient information physiotherapy following an ankle fracture. 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.
The weber classification describes ankle fractures according to their location. A retrospective cohort study in patients with a aoweber btype ankle fracture. Come out of the boot and begin to move your ankle up and down immediately after surgery so your ankle does not get stiff. Note the bimalleolar pattern with transverse fracture of the medial malleolus and oblique fracture of fibula beginning at the mortise. 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. Clinical utility of a stabilitybased ankle fracture classification system. 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. The aim of treatment is to restore and maintain stability and alignment of the joint, ideally with normal anatomy of the ankle mortise. Twenty five patients with operated weber a b c fractures. B involves a spiral fibula fracture beginning at the level of the joint and a. 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. 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.
The secondary aim was to gain insight in various factors influencing outcome. It is generally treated surgically or nonsurgically, followed by a period of immobilisation to prevent complications such as malunion. 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. This patients fracture pattern fulfils all of the criteria for operative management. 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. B refers to a transsyndesmotic fibular fracture, or a fracture between the. Over five million ankle injuries occur each year in the united states alone. Introduction ankle fractures are one of the most common lower limb fractures 1. Nonoperative stable, nondisplaced, isolated unimalleolar 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. Ankle xrays needed only if there is pain near the malleoli with one or more of following, a age 55 b inability to bear wt c bone tenderness at posterior edge or tip of either malleolus. Pdf ankle fracture is one of the most common lower limb fractures for they. Immediate unprotected weightbearing of operatively. Weber b type ankle fractures with a cast or a simple orthotic device for. Surgical vs nonsurgical management of weber b fractures.
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. Determinants of outcome in operatively and nonoperatively treated weber b ankle fractures. Please see the picture below to understand where this injury is. Objective this study aimed to determine if surgery is superior to nonsurgical management for the treatment of these fractures. The gray area of treatment lies mainly with the minimally displaced weber b type ankle fractures. The danis weber classification often known just as the weber classification is a method of describing ankle fractures. This is classified as a stable weber b type fracture. This normally takes approximately 6 weeks to unite heal although pain and swelling can be ongoing for 36 months.
Ankle fracture weber b ankle 3 east sussex healthcare. Methods a pragmatic, multicentre, singleblinded, combined randomised controlled trial and observational study. Reproducibility of the laugehansen, danis weber, and ao classifications for ankle fractures. Victoria bc v8z 0b9 tel 250 940 4444 fax 250 385 9600 page 1 april 2015 v1s. Lateral malleolar fractures occurring at the level of the ankle. Pdf standardised virtual fracture clinic management of. 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.
It was introduced by danis in 1949, modified by weber in 1966 then. Many type b fractures require operative management but not all and type c fractures tend to all require operative management. Danisweber classification of ankle fractures physiopedia. You have sustained a fracture to your fibula outside ankle bone. Tibiofibular clear space of 6 mm or more on anteroposterior radiography. Ankle fractures are the most commonly sustained fracture for patients between the ages of 20 and 65. It takes into consideration the position of the distal fibular fracture in relation to the syndesmosis of the ankle joint. The improved smallfragment implants and instruments, anatomic plates, and locking screw technology allow the effective treatment of the majority of ankle fracture patterns.
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. Background isolated type b ankle fractures with no injury to the medial side are the most common type of ankle fracture. Rehabilitation for ankle fractures in adults cochrane. There are three classifications based on the location and type of fracture. Ankle fractures are common and the majority are the result of low energy torsional trauma. 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. Three week versus six week immobilisation for stable weber b type. State the indication to fix posterior malleolar fractures. Standardised virtual fracture clinic management of radiographically stable weber b ankle fractures is safe, cost effective and reproducible article pdf available in. 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. Interobserver reliability and intraobserver reproducibility of the weber classification of ankle fractures. Three week versus six week immobilisation for stable weber. Pdf treatment of ankle fractures is often based on fracture type and surgeons. Conclusion isolated transsyndesmotic weber b ankle fractures, that are clinically and radiologically stable, can be safely treated with functional bracing.