Abstract
Submission Type:
Ankle Fractures
Research Type:
Level 3 - Retrospective cohort study, Case-control study, Meta-analysis of Level 3 studies
Introduction/Purpose:
Supination-external rotation (SER) / Weber B ankle fractures are the most common malleolar fracture. Surgical indication is well defined according to the stability of the mortise. However, in some SER type lateral malleolar fractures with suspicious medial clear space widening, it is not easy to determine the stability of them. Clinical signs and other tests have been proposed to differentiate the stability of those fractures, which seem to have major concerns and limitations. So we adopted the weight-bearing(WB) test as a simple and predictable test and report the outcomes of the SER/Weber B type lateral malleolar fractures treated non-operatively according to the WB test.
Methods:
In case of SER/Weber B lateral malleolar fractures without a definite sign of medial clear space widening, we have conducted the WB test as a stability indicator of them. If the patients with SER type lateral malleolar fractures can stand and walk at least 4 steps without any walking aid, we regarded those fractures as a stable ones for whom non-operative treatment was chosen. Between 2016 and 2023 December 79 Weber B lateral malleolar fractures underwent non-operative treatment. Among them 68 patients were followed up more than 6 months. Radiographic parameters and clinical outcomes including pain score and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score were evaluated and analyzed.
Results:
Radiographic union was achieved in all 68 cases for whom the congruency of the joint were maintained up to the last follow up without any evidence of traumatic arthritis. Additionally, no other significant findings were observed. The average VAS score was 1.03 (min 0-max 5) and the AOFAS score was 87.34 (min 58-max 100). All the patients have returned to their previous daily activity level.
Conclusion:
With these good radiographic and clinical outcomes, we think that the WB test is a simple and reliable clinical indicator to differentiate stable SER/Weber B type lateral malleolar fractures which can be treated non-operatively.