A21 Against all odds? Lateral malleolus non-union in ‘stable’ Danis-Weber type B ankle fractures

Injury ◽  
2011 ◽  
Vol 42 ◽  
pp. S6
Author(s):  
R.J. Derksen ◽  
Y. Tank ◽  
R.S. Breederveld
Keyword(s):  
Lateral Malleolus ◽  
Ankle Fractures ◽  
Type B ◽  
Non Union ◽  
Weber Type

scholarly journals Diagnosis of tibiofibular syndesmosis instability in Weber type B malleolar fractures

2020 ◽  
Vol 48 (7) ◽  
pp. 030006052093975
Author(s):  
Qiang Huang ◽  
Yongxing Cao ◽  
Chonglin Yang ◽  
Xingchen Li ◽  
Yangbo Xu ◽  
...  
Keyword(s):  
Ankle Fractures ◽  
Preoperative Imaging ◽  
Diagnostic Efficiency ◽  
Tibiofibular Syndesmosis ◽  
Type B ◽  
X Ray ◽  
Malleolar Fractures ◽  
Distal Tibiofibular Syndesmosis ◽  
Arthroscopic Findings ◽  
Weber Type

Objective This study was performed to analyze the clinical value of X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) examinations for the diagnosis of distal tibiofibular syndesmosis injuries in Weber type B ankle fractures with reference to the ankle arthroscopic findings. Methods This retrospective clinical study involved 52 patients with type B ankle fractures from August 2014 to January 2018. We analyzed the patients’ preoperative imaging data and judged the stability of the distal tibiofibular syndesmosis using X-ray, CT, and MRI examinations. We also evaluated the syndesmosis stability with arthroscopy both statically and dynamically. Results With the arthroscopic findings as the standard, the sensitivity of X-ray for diagnosing syndesmosis instability was 52.8%, the specificity was 100%, and the diagnostic efficiency was 67.3%. The sensitivity of CT for diagnosing syndesmosis instability was 77.8%, the specificity was 100%, and the diagnostic efficiency was 84.6%. The sensitivity of MRI for diagnosing syndesmosis instability was 100%, the specificity was 81.3%, and the diagnostic efficiency was 94.2%. Conclusion This study suggests that an arthroscopic examination may be recommended when the X-ray or CT features are different from the MRI findings while diagnosing tibiofibular syndesmosis instability in Weber type B malleolar fractures.

The Value of Additional Gravity Stress Radiographs for Decision Making in the Treatment of Isolated Type B Distal Fibular Fractures

2021 ◽  
pp. 107110072110010
Author(s):  
Claar A. T. van Leeuwen ◽  
Roderick W. J. J. van Dorst ◽  
Pieta Krijnen ◽  
Inger B. Schipper ◽  
Jochem M. Hoogendoorn
Keyword(s):  
Operative Treatment ◽  
Ankle Fractures ◽  
Type B ◽  
Stress Radiographs ◽  
Clear Space ◽  
Group I ◽  
Patient Reported ◽  
Weber Type ◽  
Group Ii ◽  
Mortise View

Background: Prior to treatment decisions concerning isolated Weber type B ankle fractures, assessment of the stability of the ankle joint is mandatory. The gravity stress (GS) radiograph is a radiographic tool to determine stability. We hypothesized that this additional GS radiograph would lead to fewer operative treatments by applying the criterion of operative treatment when medial clear space (MCS) > superior clear space (SCS) + 2 mm on the GS radiograph, compared with the nonstressed mortise view criteria of advising operative treatment in case of MCS > SCS + 1 mm. Methods: This retrospective comparative cohort study analyzed 343 patients aged between 18 and 70 years with an isolated Weber type B ankle fracture diagnosed at the emergency department between January 2014 and December 2019. The cohort was divided into 2 groups based on whether an additional GS radiograph was performed. Group I consisted of 151 patients in whom a regular mortise and lateral radiograph were performed. Group II comprised 192 patients, with an additional GS radiograph. Primary outcome was type of treatment (conservative vs operative). Secondary outcomes were patient-reported functional outcomes and pain. Results: Baseline characteristics of both groups did not differ. In group I, surgery was performed in 60 patients (39.7%) compared with 108 patients (56.3%) in group II ( P = .002). In the operatively treated patients, the mean MCS on regular mortise view was significantly smaller in patients in whom an additional GS radiograph was performed compared to patients without an additional GS radiograph (4.1 mm vs 5.2 mm, P < .001). Mean Olerud-Molander Ankle Score and mean visual analog scale (VAS) for pain did not differ significantly between groups I and II. Conclusions: Contrary to what was hypothesized, the introduction of an additional gravity stress radiograph, by which operative treatment was indicated if the MCS was wider than the SCS + 2 mm, did not result in reduced operative treatment of Weber type B ankle fractures when operative treatment was indicated for MCS > SCS + 1 mm on non-gravity stress radiographs. Level of Evidence: Level III: retrospective comparative study.

Percutaneous screw fixation for painful non-union of lateral malleolus ankle fractures

Injury ◽  
2018 ◽  
Vol 49 (10) ◽  
pp. 1936-1941
Author(s):  
Timothy J. Batten ◽  
Charlotte Scott-Davies ◽  
Michael Butler ◽  
Stephen W. Parsons ◽  
Richard P. Walter
Keyword(s):  
Screw Fixation ◽  
Lateral Malleolus ◽  
Ankle Fractures ◽  
Percutaneous Screw Fixation ◽  
Non Union

scholarly journals The Surgical Outcomes of Unstable Ankle Fractures in Patients Aged >65 Years

2021 ◽  
Vol 12 ◽  
pp. 215145932199776
Author(s):  
Adem Sahin ◽  
Anıl Agar ◽  
Deniz Gulabi ◽  
Cemil Erturk
Keyword(s):  
Surgical Outcomes ◽  
External Rotation ◽  
High Energy ◽  
Ankle Fractures ◽  
Medial Malleolus ◽  
Aofas Score ◽  
Non Union ◽  
The Mean ◽  
Medial Malleolus Fracture ◽  
Mechanism Of Trauma

Aim: To evaluate the surgical outcomes and complications of patients over 65 years of age, with unstable ankle fractures. Material and Method: The study included 111 patients (73F/38 M) operated on between January 2015 and February 2019 and followed up for a mean of 21.2 months (range, 6-62 months).Demographic characteristics, comorbidities, fracture type, and mechanisms of injury were evaluated. Relationships between postoperative complications and comorbidities were examined. In the postoperative functional evaluations, the AOFAS score was used and pre and postoperative mobilization (eg, use of assistive devices) was assessed. Results: The mean age of the patients was 70.5 ± 6.1 years (range, 65-90 years). The mechanism of trauma was low-energy trauma in 90.1% of the fractures and high-energy trauma in 9.9%. The fractures were formed with a SER injury (supination external rotation) in 83.7% of cases and bimalleolar fractures were seen most frequently (85/111, 76%).Complications developed in 16 (14.4%) patients and a second operation was performed in 11 (9.9%) patients with complications. Plate was removed and debridement was performed in 5 of 6 patients due to wound problems. Nonunion was developed in the medial malleolus in 4 patients. Revision surgery was performed because of implant irritation in 2 patients and early fixation loss in the medial malleolus fracture in one patient. Calcaneotibial arthrodesis was performed in 3 patients because of implant failure and ankle luxation associated with non-union. A correlation was determined between ASA score and DM and complications, but not with osteoporosis. The mean follow-up AOFAS score was 86.7 ± 12.5 (range, 36-100).A total of 94 (84.7%) patients could walk without assistance postoperatively and 92 (82.9%) were able to regain the preoperative level of mobilization. Conclusion: Although surgery can be considered an appropriate treatment option for ankle fractures in patients aged >65 years, care must be taken to prevent potential complications and the necessary precautions must be taken against correctable comorbidities.

scholarly journals Possible factors for ankle fractures

2010 ◽  
Vol 67 (3) ◽  
pp. 225-228 ◽  
Author(s):  
Dejan Tabakovic ◽  
Radovan Manojlovic ◽  
Marko Kadija ◽  
Mihailo Ille ◽  
Goran Turkovic ◽  
...  
Keyword(s):  
Body Weight ◽  
Significant Risk ◽  
Ankle Fractures ◽  
Type B ◽  
Physical Exercises ◽  
Appropriate Treatment ◽  
Fracture Body ◽  
Type C ◽  
Fracture Types

Background/Aim. Classification of ankle fractures is commonly used for selecting an appropriate treatment and prognosing an outcome of definite management. One of the most used classifications is the Danis-Weber classification. To the best of our knowledge, in the available literature, there are no parameters affecting specific types of ankle fractures according to the Danis-Weber classification. The aim of this study was to analyze the correlation of the following parameters: age, body weight, body mass index (BMI), height, osteoporosis, osteopenia and physical exercises with specific types of ankle fractures using the Danis-Weber classification. Methods. A total of 85 patients grouped by the Danis-Weber classification fracture types were analyzed and the significance of certain parameters for specific types of ankle fractures was established. Results. The proportion of females was significantly higher (p < 0.001) with a significantly higher age (59.9 years, SD ? 14.2) in relation to males (45.1 years, SD ? 12.8) (p < 0.0001). Type A fracture was most frequent in the younger patients (34.2 years, SD ? 8.6), and those with increased physical exercises (p = 0.020). In type B fracture, the risk factor was osteoporosis (p = 0.0180), while in type C fracture, body weight (p = 0.017) and osteoporosis (p = 0.004) were significant parameters. Conclusion. Statistical analysis using the Danis-Weber classification reveals that there are certain parameters suggesting significant risk factors for specific types of ankle fractures.

scholarly journals Functional outcome of bimalleolar ankle fractures treated with fibular plate for lateral malleolus and C.C. screws for medial malleolus

2020 ◽  
Vol 6 (1) ◽  
pp. 1126-1132
Author(s):  
Dr. Sachin Kale ◽  
Dr. Pratik Tank ◽  
Dr. Rahul Ghodke ◽  
Dr. Pankaj Singh ◽  
Dr. Abhiraj Patel
Keyword(s):  
Functional Outcome ◽  
Lateral Malleolus ◽  
Ankle Fractures ◽  
Medial Malleolus
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