(303):173-7. . An ankle fracture is a break in one or more of the bones of the ankle joint - the tibia, fibula and talus. Talar … 5th metatarsal base. According to Lauge Hansen the oblique fibular fracture indicates that this is a Supination Exorotation injury stage 2 or higher. - Non Operative Treatment: - isolated Weber B fractures (no medial injury) can be treated w/ a cast if there is up to 3 mm of fibular displacement; The researchers reviewed radiographs 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’s triangle. Tibiofibular clear space of ≥6 mm on anteroposterior radiography. We present a case of established nonunion of a fracture of the lateral malleolus confirmed and treated surgically, using debridement and internal fixation with autologous bone graft. Cohen DE, Van Duker B, Siegel S, Keon TP. Fig. Methods A pragmatic, multicentre, single-blinded, combined randomised controlled trial and observational study. Weber B fractures –Stable if undisplaced and mortice intact –Full below knee plaster with crutches –Re Xray at 1 – 2 weeks –Plaster for 6 weeks total –X ray at 6 weeks out of plaster –Clinical union = no pain The majority of these fractures represent stable injuries, and may be treated with a short period of non-weight bearing immobilization. Acute ankle fractures are among the most common sports fractures affecting the lower limb (1,2).Syndesmotic injuries may be present and are often associated with Weber type C Ankle Fracture (3,4).In these cases, an accurate reduction of the fibula in the fibular notch and the assessment of the presence of chondral lesions are essential to obtain good clinical outcomes (4-7). Stage 1: tear of anterior-inferior tibiofibular ligament (AITFL) or avulsion of anterior tibia. Fibular avulsions of the AITFL (“Wagstaffe fracture”) are reported to be predictive of ankle diastasis in Weber type B lateral malleolar fractures . Although it is widely used in clinical practice, it has been criticized mainly due to numerous reports of cases conflicting the prediction system. van den Berg C, Haak T, Weil NL, Hoogendoorn JM. ANKLE FRACTURE •Indication for Ortho Referral • Weber Type B, C • Bi or Trimalleolar Fracture • Posterior Malleolar Fracture with >25% articular involvement or >2mm step off • Lateral Malleolus Fracture Displaced >3mm • Displaced Medial Malleolar Fracture b Reposition and central 2 mm guidewire. No talar tilt, syndesmotic injury, or other fractures were noted (Figure ). Supination-external rotation (SER): ~60% of ankle fractures. The accurate Methods This study reviewed 94 cases of ankle fractures treated with operative methods. Lateral malleolar fractures Non Operative Treatment 2. The purpose of this study was to evaluate syndesmotic stability with respect to the current recommendations for syndesmotic fixation in Weber B SE pattern lateral malleolar fractures. The superficial component ruptures were sutured with absorbable suture. Martin Weber, M.D Bern, Switzerland ABSTRACT Background: Trimalleolar fractures usually include a lateral malleolar fracture, a triangular fracture of the posterolateral corner of the tibial plafond, and a hori-zontal or oblique fracture of the medial malleolus. Both stress views measure the medial clear space, which is the distance between the lateral border of the medial malleolus and the medial border of the talus at the level of the talar dome. P.AB. Medial column (deltoid ligament) integrity is of key importance when considering the stability of isolated lateral malleolus ankle fractures.Weight-bearing radiographs are the best method of evaluating stability of isolated distal fibula fractures.Computed tomography (CT) scanning is mandatory for the assessment of complex ankle fractures, especially those involving the posterior malleolus.Most isolated trans-syndesmotic fibular fractures (Weber-B, SER, AO 44-B… The generally accepted treatment of displaced or unstable Weber B ankle fractures involves 1. fixate fibula with plate and screws. Fortunately is that separated lateral malleolus fractures are usually stable ankle fractures and for that reason do not have this issue. anterior tibiofibular ligament avulsion fracture (Wagstaffe fracture) combined with the Weber type B lateral malleolar fracture. There are three classifications based on the location and type of fracture. The posterior malleolar fracture was treated similar to the AO/OTA type-B fracture. P.ER. Weber B fibula fracture is open reduction and internal fixation (ORIF) using a plate and screws to anatomically reduce and. S.ER. Pilon fx: tibial plafond fx due to axial load. The Danis-Weber classification[1] (Weber classification) is a simple method for classifying fractures of lateral ankle fractures and is based on radiographic criteria. 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. Plain anteroposterior and lateral radiographs of the left ankle revealed a nondisplaced, short, oblique fracture of the lateral malleolus, Danis-Weber B. Injury 2018; 49:1607. Comparison of two conservative methods of treating an isolated fracture of the lateral malleolus. CT [33] [20] CT-scan in the case of the Ankle fractureis the best modality if you can not have an exclusive diagnosis by X … B . They are inherently unstable and are more likely to require operative repair to achieve a good outcome. - Malleolar – either medial or lateral - Bimalleolar – both medial and lateral - Trimalleolar – includes posterior malleolus The direction of the force determines the fracture pattern – external rotation, abduction, adduction. If your injury is classified as a stable Weber B type fracture, you will be treated in a boot. 2). Weber B . #columbiamed #whitecoatceremony” The Danis-Weber classification[1] (Weber classification) is a simple method for classifying fractures of lateral ankle fractures and is based on radiographic criteria. In treating Weber B fibular fractures the emphasis is on the restoration of fibular length and rotation (Figure 21.7). The malleolar fracture usually starts medially at the level of the talar dome, but can also start a few centimeters above this level. d Soft tissue after shortening the screw wires. Physical Therapy Guidelines for Ankle Fracture with Surgery This was written and developed by the therapists of MGH Physical Therapy Services. Common peroneal nerve palsy associated with epidural analgesia. The three aforementioned parts of bone articulate with the talus bone of the foot. Background Isolated type B ankle fractures with no injury to the medial side are the most common type of ankle fracture. Treatment is nonoperative for syndesmotic sprains without diastasis or ankle instability. Use the video or information below to gain a better understanding of your injury and what can be done to maximise your recovery. Mirzayan R, Sherman B, Chahla J. Cryopreserved, viable osteochondral allograft for the treatment of a full-thickness cartilage defect of the glenoid. B - the fracture is at the level of the syndesmosis (most common). • fracture extends through the physis and exits through the epiphysis • seen with medial malleolus fractures and Tillaux fractures • increased risk of physeal arrest: Type IV: 25% • fracture i nvolves the physis, metaphysis and epiphysis • can occur with lateral malleolus fractures, usually SH I or II 2923 N California Ave Suite 300 Chicago, IL 60618 Phone: (847) 247-4000 720 Florsheim Drive Libertyville, IL 60048 Phone: (847) 247-4000 The more bones that are broken, generally the worse the injury. The AO/Danis-Weber and Lauge-Hansen systems are the most commonly used classifications to describe ankle fractures. A/P, Lateral and Mortise views of the ankle and AP, lateral views of the entire length of the tibia and fibula. unstable fractures of the lateral malleolus . Re-examination Order an x-ray of the proximal fibula when pain is detected with palpation. 2. posterior fragment fixed if >25% joint involved. 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 lower part of this ligament is by some considered a separate ... principles of fracture treatment. Malleolus fx: due to shear or twisting forces. The images show a Weber B fracture. Weber A: walking cast or boot, WBAT. Ankle Fracture – Weber B. Weber B - a fracture at or near the level of the syndesmosis. A . Weber B lateral malleolus fractures are commonly seen in clinical practice, and are described as the fractures with a trans-syndesmosis fracture line at the lateral malleolus [1,2] According to Danis–Weber classification, it can be simplified as lateral malleolus fracture and syndesmosis injury only, ignoring the medial structure injury. An isolated lateral malleolus fracture may be an incomplete Weber A , but it could also be a occult Weber B or C where the only bony fracture is of the distal fibula. They are classified as either: A - the fracture is below the syndesmosis. Weber B, displaced: short leg backslab, NWB . Please see the picture below to understand where this injury is. In addition, there is an associated fracture of the medial malleolus or rupture of the deep deltoid ligament. No talar tilt, syndesmotic injury, or other fractures were noted (Figure 1). The patient was managed conservatively with a below knee full cast and was kept non-weight bearing. Maisonneuve fx: fx of proximal fibula due to pronation-external rotation (PER) injury of ankle. May secondarily involve malleoli. Types II and III fractures have two or three fragments, respectively, which are then subdivided, depending on the medial or lateral position of the primary fracture line. BMJ 2019; 364:k5432. Current recommendations suggest that Weber B injuries should not have associated syndesmotic instability after open reduction and internal fixation of the lateral malleolus. CONCLUSION:A reasonably good stability can be obtained in distal most comminuted fractures of lateral malleolus with a lateral malleolus anatomical hook plate. The mission of The Journal of Foot & Ankle Surgery is to be the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Plain anteroposterior and lateral radiographs of the left ankle revealed a nondisplaced, short, oblique fracture of the lateral malleolus, Danis-Weber B. Sometimes a Plaster is used. Small avulsion Danis-Weber type A fractures without medial-sided injury can be symptomatically treated with a walking cast or stirrup brace and ambulation as tolerated. Weber B fractures occur at the level of the tibiofibular ligaments, just above the talar dome, and happen primarily through a mechanism of ankle supination and external rotation (SER). 2002 Apr. open ankle fractures. Because our Emory Reproductive Center nurses are the absolute best! Park JW, Kim SK, Hong JS, et al. Sometimes a Plaster is used. In treating Weber B fibular fractures the emphasis is on the restoration of fibular length and rotation (Figure 21.7). Calcaneofibular ligament lies deep in relation to peroneal tendons and extends from lateral malleolar tip to trochlear eminence, stabilizing subtalar joint. 3 These type B fractures are sometimes stable, and patients can ambulate on them as tolerated; in other cases, they are unstable and require open reduction and internal fixation (ORIF). Conclusion: Patients mostly were young. Fracture lines A, B, and C describe the position of the primary fracture line in relation to the posterior facet and the subtalar joint. A lateral malleolus fracture is a relatively common condition characterized by a break in the bony prominence situated at the outer aspect of the ankle known as the lateral malleolus (figure 1). The commonly used Weber classification relies solely on the level of the lateral malleolar fracture relative to the ankle joint line.3 The mechanism of injury generally involves a twisting or The Lauge-Hansen (LH) classification attempts to predict patterns of ankle injuries based upon the preceding mechanism of injury. More proximal, edema is seen around the membrana interossei. Stage 3: Tear of the posterior-inferior tibiofibular ligament (PITFL) or avulsion of posterior malleolus. Weber type B fractures. Fracture of the lateral malleolus starting anteriorly at the level of the joint extending proximally posteriorly. Mechanism is supination of the foot. Perry JJ, Stiell IG. There is also a fracture of the malleolus tertius (blue arrow). Lateral Malleolus Fracture. If the fracture is out of place or your ankle is unstable, your fracture may be treated with surgery. This trauma know as injury to the distal fibula of the ankle as well. The lateral malleolus is the name provided to the bone on the outside of the ankle joint. This bone is part of the fibula,... Classification The fracture is classified according to Weber as a type B fracture. 2. fixate medial mall. Hence, the key for treating this type of fracture … Two joints are involved in ankle fractures: Ankle joint - where the tibia, fibula and talus meet. If the Orthopaedic Consultant considers this unstable, an operation with plate and screws may be required. Immobilization is continued for a total of approximately 6-8 weeks with a skin check at 3-4 weeks. Danis-Weber: based on level of fibular fracture relative to syndesmosis (A-infra, B-trans, C-supra) Lauge-Hansen: describes the position of the foot & the motion of the talus with respect to the leg; Danis-Weber Classification. Delay in definitive treatment of up to a week post-fracture Treatment: bimalleolar equivalent fracture. Setting Two major trauma centres in … Such fractures most often occur as … Treatment can be nonoperative or operative depending on fracture displacement, ankle stability, syndesmosis injury, and patient activity demands. Ankle diastases were diagnosed in 20 cases (38.5%) in all Weber type B fractures and 11 (84.6%) of the 13 Wagstaffe fractures. At follow-up, definitive treatment is dictated by the type of fracture. Here, we report a case of a 32-year-old male who sustained a Weber B fracture of the lateral malleolus following a supination ankle injury, which was treated It is a break of the lateral malleolus, the knobby bump on the outside of the ankle (in the lower portion of the fibula). Lateral malleolus avulsion fracture This information will guide you through the next 6 weeks of your rehabilitation. Thirty-six fractures were clas- sified as Weber B and 10 as Weber A. Allmedial mal- leolus fractures were fixed with one or two cancellous screws. If surgery is not required: closed Symptoms may include pain, swelling, bruising, and an inability to walk on the injured leg. There are three classifications based on the location and type of fracture. Twenty-five patients had a medial malleolus fracture, with 15 of these being bimalleolar and 10 being trimalleolar. The most common ankle fractures are breaks of the lateral malleolus (end of the fibula), medial malleolus (inside end of the tibia) or both, which is called a ‘bimalleolar fracture’. The AO/Danis-Weber classification is an anatomic system based upon the location of the fracture with regard to the tibiotalar joint (Weber A—below the joint; Weber B—at the joint; Weber C—above the joint). The goal of treatment is to maximize the long term function of the ankle by restoring and maintaining alignment. Weber C fracture or a PER stage 4 according to Lauge-Hansen. This is an unstable fracture that needs surgical repair. The ankle circle is interrupted at two places i.e. the medial malleolus and the syndesmosis. A syndesmotic screw was inserted. 2018;7(12):e1269-e1273. C - the fracture is above the syndesmosis. Re-examination Weber C fractures; some Weber B fractures. operative, open or closed Weber B fracture outcomes. The Weber C fractures managed operatively had a significantly lower AOFAS, 63 compared to non-operative cases who scored 84.3. Weber fracture: is a fracture of the end of the fibula (lateral malleolus). (OBQ09.52) In which of the following radiographs of different types of ankle fractures should the medial malleolus be treated with screw fixation directed parallel to the ankle joint? Tested Concept (OBQ09.121) A 31-year-old male sustains an irreducible ankle fracture-dislocation with the foot maintained in an externally rotated position. Weber C - a fracture above the level of the syndesmosis. ... isolated lateral malleolus fracture with < 3mm displacement and no talar shift. Stage 2:Spiral fracture of the lateral malleolus at and above level of mortise. Classification The fracture is classified according to Weber as a type B fracture. medial malleolus fracture or deltoid ligament injury present; unstable: requires ORIF; Categories B and C imply a degree of damage to the syndesmosis itself (which cannot be directly visualised on X-ray). Am J Sports Med. CONCLUSION: The Wagstaffe fracture can be a good diagnostic clue of ankle diastasis in Weber type B lateral malleolar fracture. The patient was managed conservatively with a below knee full cast and was kept non-weight bearing. isolated medial malleolus fracture. A lateral or posterolateral neutralization plate is then used to stabilize the construct. Use either a well-padded posterior splint or a stirrup splint to keep the patient from bearing weight on the ankle until definitive treatment is instituted in 3-4 days. Lauge-Hansen . There is often a long oblique fracture pattern, which lends itself to lag screw fixation with either one or two screws. e patient was continued on the same treatment. Fibula fracture above syndesmosis (Weber C) Ankle in normal anatomical position: short leg backslab NWB. Type IV fractures are severely comminuted. Critical review of the LH classification along with its shortcomings is discussed. Why? Weber B. Posterior Malleolus Fracture: Radiographic Evaluation Indication for fixation: > 25% joint surface on lateral Problem: Fragment size hard to determine on lateral view – Reason: Fracture orientation not purely in coronal plane •Nearly always associated with the pull of the posterior tib-fib ligament – larger laterally than medially Weber ER, Daube JR, Coventry MB. Objective This study aimed to determine if surgery is superior to non-surgical management for the treatment of these fractures. 8 Type B fractures may be associated with a stable ankle joint. bimalleolar and bimalleolar-equivalent fractures. It takes into consideration the position of the distal fibular fracture in relation to the syndesmosis of the ankle joint. 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]. 1. reduce lateral and medial fractures. 1,771 Likes, 65 Comments - Mitch Herbert (@mitchmherbert) on Instagram: “Excited to start this journey! Repeated plain radiographs taken during a follow-up 2 weeks later showed no displacement. Nonunion of a fracture of the lateral malleolus is a rare condition. The focus of this article is to help … Stage 2: Short oblique fracture of the lateral malleolus (Weber B) (stable) Stage 3: Rupture of PITFL / fracture of posterior malleolus of tibia. Definitions. Check for tenderness of the medial malleolus to test if the deltoid ligament is ruptured. Ligaments may also be torn during the injury. If your injury is classified as a stable Weber B type fracture, you will be treated in a boot. Fractures (fxs) of distal tibia and fibula are divided into. J Trauma. The choice between conservative and operative treatment will depend on individual circumstances. If the Orthopaedic Consultant considers this unstable, an operation with plate and screws may be required. Lateral malleolus; Shin bones - Medial malleolus; Kneecap - patella; You can find an overview of all Dr-Gumpert images at: medical illustrations. C . 52(4):655-9. . Lateral Malleolus Fracture. 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. Patients in group B were treated in a supine position. Early range of motion is initiated once swelling and tenderness has diminished, and weight bearing is usually possible within 10–14 days of the injury in a fracture boot. Mechanism is external rotation of the foot. 27 A medial clear space of greater than 5 mm is predictive of a deep deltoid ligament injury and thus an unstable ankle fracture. Injury patterns. A Weber type B fracture occurred in 76% and a Weber type C fracture in 24%. Syndesmosis joint - the joint between the tibia and fibula. Moore DR, Cain EL, Schwartz ML, Clancy WG Jr. Allograft reconstruction for massive, irreparable rotator cuff tears. Isolated lateral malleolus. 42 As a result, these injuries result in a partial, or occasionally complete, rupture of the syndesmosis. Etiology. (Harper MC, Foot Ankle 1989; 10: 156). Academia.edu is a platform for academics to share research papers. 2 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 soft Fracture of the lateral malleolus starting anteriorly at the level of the joint extending proximally posteriorly. 1994 Jun. Stable ankle fractures (such as the majority of Weber A and B fractures) have great prognosis and can be treated conservatively. c Insertion of the XS nail with aiming device. Introduction. Undisplaced and minimally displaced isolated lateral malleolar fractures (Weber B) usually unite without operative intervention. lateral malleolus, Danis-Weber B. In this case report, we present a patient with a severed ATFL (midsubstance tear) and a nondisplaced oblique fracture of the lateral malleolus at the left of the syndesmosis. The AITFL was intact. This fracture pattern does not translate to any class of the LH classification system. The shaft of the femur connects the superior and inferior ends, transmitting the body’s weight to the knee joint and tibia.. Weber . The patient was continued on the same treatment. Kortekangas T, Haapasalo H, Flinkkilä T, et al. The AITFL provides significant resistance to further external rotation of the talus after an experimental fibular fracture … Weber B Fracture of the Lateral Malleolus with Concomitant Anterior Talofibular Ligament Injury following an Ankle Supination Injury MohammedKhalidFaqi,AbdullaAlJawder,FahadAlkhalifa,andAliH.Almajed DepartmentofOrthopedicSurgery,BahrainDefenceForceHospital-RoyalMedicalServices,Riffa,Bahrain No poste rior malleolar fractures required fixa- Weber A describes a fibula fracture distal to the syndesmosis, B is at the level of the syndesmosis, and C is proximal to the syndesmosis.5 Calcaneus fracture —Fracture of the anterior process of the calcaneus presents with lateral ankle pain and pain on palpation inferior to the lateral malleolus. Treatment can be nonoperative or operative depending on fracture displacement, ankle stability, syndesmosis injury, and patient activity demands. 2006 Dec. 37(12):1157-65. Results There were 52 cases of Weber type B lateral malleolar fractures and 13 cases of Wagstaffe fractures combined with them (25%). Support of Ventilation. Design Randomised, pragmatic, non-inferiority, clinical trial with blinded outcome assessment. Initial treatment involves the use of a cast or fracture boot (3). It has a role in determining treatment. 2. hook test then syndesmotic screws. Injury. May be associated with medial ankle injury/fracture or posterior malleolus fractures. This patient’s fracture was consistent with a stable Type B fracture, which is defined as a spiral fracture of the lateral malleolus of the distal fibula, beginning at the level of the joint and including a partial syndesmotic injury. A Weber B fracture occurs due to a rotational injury with the development of an oblique fracture line starting at the tibia plafond (3). According to Lauge Hansen the oblique fibular fracture indicates that this is a Supination Exorotation injury stage 2 or higher. posterior malleolus fractures. Abstract. 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. e patient was managed conservatively with a below knee full cast and was kept non-weight bearing. Orthopaedic follow-up in ED or within 1-2 days. Weber B, undisplaced: short leg backslab NWB. If there is a lot of soft tissue swelling over the lateral malleolus, but no fracture, then there has been a ligamentous injury. Nevertheless, controversy remains with regard to the optimal method of fixation. Impact of clinical decision rules on clinical care of traumatic injuries to the foot and ankle, knee, cervical spine, and head. Anterior tibiofibular ligament avulsion fracture in weber type B lateral malleolar fracture. 24-year-old man with Weber type B fracture of fibula. Orthopaedic follow up in 7-10 days. The lateral and, if present, the medial malleolus fracture were treated first, through a direct lateral and direct medial approach. A high index of suspicion is needed. For the patients who underwent repair of the DL, reinsertion to the medial malleolus or talus was achieved by suturing directly to the bone, and enhanced with a suture anchor (Fig. These are common, accounting for 60% of all ankle fractures [1]. According to the Lauge–Hansen classification [], 46% had a pronation abduction stage 3 (PA-3) fracture, 24% a pronation external rotation stage 4 (PE-4) fracture, 4% a supination external rotation stage 3 (SE-3) fracture and 26% a SE-4 fracture.No Weber type A or supination adduction fractures were seen in … a Accident X-ray image, AP and lateral, of a simple Weber B fracture. Note skin integrity and areas of tenderness or crepitus over ankle No talar tilt, syndesmotic injury, or other fractures were noted (Figure 1). ... Weber B. other. Hence, defining the stability of ankle fracture is of utmost importance. Physical Therapy As always, acute management of ankle fractures involves analgesics for pain, immobilization, and patient comfort. Lateral malleolus fracture: This is the most common type of ankle fracture. Anesth Analg. Weber A variant lateral malleolus fractures present another clinical dilemma. You have sustained a fracture to your fibula (outside ankle bone). You have sustained a fracture to your fibula (outside ankle bone). Medial clear space greater than 4mm was associated with a poor outcome. Calcaneofibular is often partially imaged in coronal or axial planes; multiple images are often needed to visualize its entire course. Distal Fibula Fracture or Lateral Malleolus Fracture (see Weber Classification below) Most common Ankle Fracture type (accounts for 55% of Ankle Fractures) Mechanisms include inversion, twisting (spiral Fracture) or direct blow to the lateral malleolus (transverse Fracture) Talus Fracture (Snowboarder's Fracture) A trimalleolar fracture is a fracture of the ankle that involves the lateral malleolus, the medial malleolus, and the distal posterior aspect of the tibia, which can be termed the posterior malleolus.The trauma is sometimes accompanied by ligament damage and dislocation.. We would like to show you a description here but the site won’t allow us. A lateral or posterolateral neutralization plate is then used to stabilize the construct. Weber A - a fibular fracture below the level of the syndesmosis. Population/sample size/setting: - 81 patients (41 men, 40 women, mean age 41) treated for acute fractures of the lateral malleolus at the University of Ontario - Entry criteria were skeletal maturity but age under 65 with isolated Weber B The lower leg comprises of 2 long bones, known as the fibula and the tibia, which are situated beside each other (figure 2). anterior process of calcaneus. 60% of ankle fractures involve only the lateral malleolus.1 Fractures of the lateral malleolus proximal to the joint line correspond to syndesmotic injuries. The method of advanced airway support (endotracheal intubation versus laryngeal mask versus bag-mask) provided to the patient should be selected on the basis of the training and skill level of providers in a given advanced life support (ALS) system and on the arrest characteristics and circumstances (eg, transport time and perhaps the cause of the arrest). Here, we report a case of a 32-year-old male who sustained a Weber B fracture of the lateral malleolus following a supination ankle injury, which was treated conservatively, following which the patient presented with ankle instability and was found to have concurrent anterior talofibular ligament tear. Weber B ankle fractures are oblique fractures of the distal fibula with a fracture line beginning at the level of the tibial plafond. These fractures are rotational injuries caused by a supination-external rotation (SER) mechanism according to the Lauge-Hansen classification [2]. Ankle Fracture – Weber B. These fractures are unstable and require urgent treatment. Type A fractures are usually stable and can be managed with simple measures, such as a plaster of … As pain improves, a patient can be advanced to weight bearing and there should also be a focus on early range of motion activities (4).
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