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J Am Acad Orthop Surg. 2016 Sep;24(9):645-52. doi: 10.5435/JAAOS-D-16-00085.

A Novel Algorithm for Isolated Weber B Ankle Fractures: A Retrospective Review of 51 Nonsurgically Treated Patients.

Author information

1
From the University of Michigan, Ann Arbor, MI (Dr. Holmes, Dr. Acker, Ms. McKinney, and Dr. Irwin), Reconstructive Orthopaedics and Sports Medicine, Cincinnati, OH (Dr. Murphy), and Northwestern University Feinberg School of Medicine, Chicago, IL (Dr. Kadakia).

Abstract

INTRODUCTION:

Stability of isolated Weber B ankle fractures can be difficult to determine. Using weight-bearing radiographs, a reliable method to determine the stability of isolated Weber B ankle fractures is described.

METHODS:

A retrospective review of prospectively gathered data was performed. Weber B ankle fractures were defined as stable when having a medial clear space (MCS) of <7 mm on initial gravity stress radiographs and a normal mortise relationship on weight-bearing radiographs. Fifty-one patients meeting these criteria were treated nonsurgically with protected weight bearing and serial radiography for 1 year.

RESULTS:

Average functional score results were: American Orthopaedic Foot and Ankle Society Hindfoot, 93.2; Foot and Ankle Ability Measure for Activities of Daily Living, 93.2; Olerud-Molander Ankle Score, 91.0; and visual analog scale pain score, 0.57. Despite a mean gravity stress MCS of 4.42 mm, no patient demonstrated subsequent MCS widening. Mean MCS on 1-year follow-up weight-bearing radiographs was 2.64 mm.

CONCLUSION:

Weight-bearing ankle radiographs are predictive of stability in isolated Weber B ankle fractures. Gravity stress radiographs using traditional measurement criteria may overestimate instability in these injuries. Nonsurgical treatment with protected weight bearing shows good early outcomes.

LEVEL OF EVIDENCE:

IV.

PMID:
27509039
DOI:
10.5435/JAAOS-D-16-00085
[Indexed for MEDLINE]

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