scholarly journals One‐Third Tubular Plate Remains a Clinically Good Option in Danis‐Weber Type B Distal Fibular Fracture Fixation

2021 ◽  
Author(s):  
Jae Hoon Ahn ◽  
Sung Hyun Cho ◽  
Mingi Jeong ◽  
Yoon‐Chung Kim
Keyword(s):  
Fracture Fixation ◽  
Good Option ◽  
Type B ◽  
Fibular Fracture ◽  
Weber Type

scholarly journals New “Freer test” for assessment of syndesmotic diastasis -Cadaveric study

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0029
Author(s):  
Jinsu Kim ◽  
Young-uk Park ◽  
Kyung-tai Lee ◽  
Kiwon Young ◽  
Sang Lee
Keyword(s):  
Diagnostic Value ◽  
Type B ◽  
Interosseous Ligament ◽  
Firm Structure ◽  
Tibiofibular Ligament ◽  
Fibular Fracture ◽  
Probe Test ◽  
Anterior Inferior Tibiofibular Ligament ◽  
Weber Type ◽  
Fibular Fixation

Category: Sports Introduction/Purpose: Syndesmotic stability is usually assessed arthroscopically by an arthroscopic probe insertion between the anterolateral tibio-fibular recess. This probe test can predict the syndesmotic instability, however, is difficult to determine syndesmotic fixation. The syndesmosis has dynamic motion and fairly firm structure, 2 mm thin probe cannot make syndesmotic dynamic diastasis. We proposed a new “Freer test” for diagnosis of syndesmosis injury which performed to insert a 2 mm diameter freer elevator between tibio-fibular lateral gutter while keeping the ankle at the plantigrade. The purpose of the present study was to evaluate the diagnostic value of freer test for anterior inferior tibiofibular ligament (AITFL) complete tear, interosseous ligament (IOL) tear and Weber type B fibular fracture. Methods: Ten fresh ankle cadaveric specimens were used. Operative procedures progressed as below; firstly, exposed antero-lateral ankle joint with direct lateral longitudinal incision, incised AITFL, incised IOL, performed Weber type B osteotomy at fibular, fixed the osteomized fibular with 8-hole locking plate and fixed the AITFL with suture anchors. In each procedure, freer tests with ankle dorsiflexion (DF, plantigrade) and plantarflexion (PF) were performed with freer elevator linked 3 kgf compression gauge. A negative test was defined as the freer did not insert with a more than 3 kgf. A positive test was defined lesser than 3 kgf, and measured the force at the insertion. Results: All freer test was negative with DF before procedures. Six ankles with PF were positive with average 1.5 kgf. All freer test positive has shown after AITFL cutting in DF, PF(mean 1.76 kgf, 1.19 kgf). After IOL cutting, all freer tests were positive in DF, PF(mean 1.46, 0.79 kgf). After fibular osteotomy, all freer tests were positive in DF, PF (mean 0.83,0.18 kgf). After fibular fixation with plate, all freer tests were positive in DF, PF (mean 1.26, 0.97 kgf). After syndesmotic fixation with anchors, 8 freer tests were positive in DF. 2 negative in PF, 4 negative in PF and 6 positive in PF. 2 positive in DF had partial breakage on anchor footprint due to weak bone. Conclusion: The “freer test” is useful diagnostic tool which test positive means AITFL rupture.

Clinical comparison of two plate systems for distal fibular fracture fixation

2017 ◽  
Vol 23 ◽  
pp. 36-37
Author(s):  
Y.C. Kim ◽  
C.J. Park ◽  
C.W. Lee ◽  
J.H. Ahn
Keyword(s):  
Fracture Fixation ◽  
Clinical Comparison ◽  
Fibular Fracture

scholarly journals Reporting Discrepancy Resolved by Findings and Time in 2947 Emergency Department Ankle X-rays

2019 ◽  
Vol 49 (4) ◽  
pp. 601-611 ◽  
Author(s):  
Thomas James York ◽  
P. J. Jenkins ◽  
A. J. Ireland
Keyword(s):  
Emergency Department ◽  
Working Hours ◽  
High Standard ◽  
Causative Factor ◽  
X Rays ◽  
Type B ◽  
Complete Dataset ◽  
Specific Finding ◽  
Weber Type ◽  
Major Discrepancy

Abstract Aims To identify common errors in ankle X-ray reporting between initial interpretation and final assessment at the virtual fracture clinic. Also, to assess time of initial reporting as a causative factor for discrepancy. Methods Two thousand nine hundred forty-seven final reports were reviewed by standard of agreement to the initial interpretation. Where discrepancy was found, it was classified and collated by specific finding. Comparison was made between reports with discrepancy and the complete dataset, allowing rates of error by finding to be established. The reports containing discrepancy were further classified by time period, this was compared against an expected value to establish if initial reporting outside of routine working hours was as accurate as that conducted within routine working hours. Results 94.4% of reports were in agreement with the initial interpretation, 2.9% contained minor discrepancy, and 2.7% major discrepancy. In 45.6% of reports there was no radiologically observable injury. 16.4% of reports contained a lateral malleolar fracture, most commonly Weber type B. 40.0% of all navicular fractures, and 33.3% of all cuboidal fractures were not commented upon in the initial reporting. Lower rates of more frequently observed findings were missed with 2.5% of Weber type B fractures not commented upon. An increased proportion of major discrepancy reports were generated from 00:00 to 07:59 (expected = 15.0%, observed = 22.2%; p = 0.07908). Similarly, a greater than expected number of minor discrepancy reports were found between 20:00 and 23:59 (expected = 18.0%, observed = 34.1%, p = 0.00025). Conclusions The initial reporting of ankle X-rays in the emergency department is performed to a high standard, however serious missed findings emphasise the need for timely senior review. Reporters should increase their awareness of navicular, cuboid, talar, and Weber A fractures which were missed at disproportionate rates. This study also finds evidence to support increased rates of error in initial reporting of ankle X-rays outside of normal working hours (17:00–07:59), particularly with a significantly increased rate of minor discrepancy seen from 20:00 to 23:59.

The Treatment of Danis-Weber Type B Fractures of the Distal Fibula by Multiple Kirschner Wires Fixation

2000 ◽  
Vol 13 (3) ◽  
pp. 529 ◽  
Author(s):  
Ho Yoon Kwak ◽  
Baik Young Song ◽  
Sang Wook Bae ◽  
Nam Hong Choi ◽  
Jin Young Kim
Keyword(s):  
Type B ◽  
Kirschner Wires ◽  
Distal Fibula ◽  
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 Dorsal Antiglide Plate in the Treatment of Dank-Weber Type-B Fractures of the Distal Fibula

1990 ◽  
Vol &NA; (259) ◽  
pp. 204???209
Author(s):  
BENEDIKT WINKLER ◽  
BERNHARD G. WEBER ◽  
LEX A. SIMPSON
Keyword(s):  
Type B ◽  
Distal Fibula ◽  
Weber Type

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.

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