Fractures of the Ankle Joint: Investigation and Treatment Options. Goost H, Wimmer M, Barg A, Kabir K, Valderrabano V, Burger C. Evaluation of the Syndesmotic-Only Fixation for Weber-C Ankle Fractures with Syndesmotic Injury. CURRENT Diagnosis & Treatment in Orthopedics, Fourth Edition. Musculoskeletal Eponyms: Who Are Those Guys? Radiographics. It was later modified and popularized by the Swiss orthopedic surgeon, Bernhard Georg Weber (1929-2002), in 1972 2. 27792 - Open treatment of distal fibular fracture (lateral malleolus), includes internal. This classification was first described by the Belgian general surgeon, Robert Danis (1880-1962), in 1949. Answer: Depending on whether the surgeon performed an open or closed repair, you should select a code from the following range for a Weber B fracture: 27786 - Closed treatment of distal fibular fracture (lateral malleolus) without manipulation. Usually associated with an injury to the medial side Weber C fractures can be further subclassified as 6Ĭ1: diaphyseal fracture of the fibula, simpleĬ2: diaphyseal fracture of the fibula, complexĪ fracture above the syndesmosis results from external rotation or abduction forces that also disrupt the joint Medial malleolus fracture or deltoid ligament injury often presentįracture may arise as proximally as the level of fibular neck and not visualized on ankle films, requiring knee or full-length tibia-fibula radiographs ( Maisonneuve fracture) Tibiofibular syndesmosis disruption with widening of the distal tibiofibular articulation Weber B fractures could be further subclassified as 9ī2: associated with a medial lesion (malleolus or ligament)ī3: associated with a medial lesion and fracture of posterolateral tibiaĪbove the level of the syndesmosis (suprasyndesmotic) Variable stability, dependent on the status of medial structures (malleolus/ deltoid ligament) and syndesmosis may require open reduction and internal fixation (ORIF) After history and physical exam suggested a potential fracture, point-of-care ultrasound (POCUS) demonstrated a cortical defect of the distal fibula, consistent with fracture. Tibiofibular syndesmosis usually intact, but widening of the distal tibiofibular joint (especially on stressed views) indicates syndesmotic injuryĭeltoid ligament may be torn, indicated by widening of the space between the medial malleolus and talar dome Usually stable if medial malleolus intact treat with CAM Walker or Moon Boot with crutches and weight bear as tolerated with them for 6 weeksĭistal extent at the level of the syndesmosis (trans-syndesmotic) may extend some distance proximally All rights reserved.Below the level of the syndesmosis (infrasyndesmotic) MIPO Weber B ankle fracture minimally invasive.Ĭopyright © 2016 American College of Foot and Ankle Surgeons. The results of the present study have demonstrated that percutaneous plating is an effective surgical option for treating Weber B distal fibular fractures. Hardware removal was required in 3 patients during the study period, which had an average of almost 4 years postoperatively. The time required to return to activity was 4.3 ± 2.0 months. The postoperative Roles and Maudsley scores had improved significantly. All fibular fractures had healed clinically and radiographically by 8 weeks after surgery. The Roles and Maudsley score was used to assess the patients' activity level. A 4- to 6-hole semitubular plate with 3 screws was used for percutaneously plating. The data from 17 patients undergoing percutaneous plating of a distal fibular (Weber B) fracture were prospectively studied. The purpose of the present study was to describe a minimally invasive percutaneous technique for plating Weber B distal fibular fractures and to evaluate its efficacy by measuring patient outcomes and hardware removal rates.
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