Functional bracing safe and cost effective treatment for isolated Weber B fracture: Study

Written By : Dr Supreeth D R |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-04-13T09:00:45+05:30 | Updated On 13 April 2022 9:01 AM IST

Despite the current recommendations that stable Weber B ankle fractures can be treated with functional bracing and weight bearing as tolerated, some reluctance exists among trauma surgeons to follow these recommendations. The paper by Ahmed Abdelaal & Sherif Elnikety reports on their institution's experience in managing these injuries and compares it to the national guidelines.

This is a retrospective cohort study. Consecutive patients with isolated Weber B fractures referred to the local outpatient clinic over the period of six months were included in the study. Radiographs and clinic letters were examined, the patients were interviewed via telephone to obtain outcome scores [Olerud and Molander score]. Method of immobilisation, weight-bearing status, radiological fracture union, clinical outcomes and complications were all assessed and analysed.

Results:

• 123 patients with isolated Weber B fractures were identified.

• This cohort of patients did not show clinical or radiographic evidence of instability, they were deemed stable and were initially treated non-operatively.

• Minimum follow-up period was six months.

• 62 were treated in plaster and was non-weight bearing on the affected limb, while 61 were treated with functional bracing in a boot and were allowed early weight bearing.

• Three patients showed displacement requiring surgical fixation.

• All fractures progressed to union and patients were discharged irrespective of the method of immobilisation or weight bearing status during treatment.

• There was no statistically significant difference in the functional outcome measures between the two groups.

• The protocol of functional bracing and weight bearing was associated with fewer outpatient clinics and a reduced number of radiographs obtained in the clinic and fewer complications.

The authors concluded that - in the absence of clinical and radiological evidence of instability, Weber B trans-syndesmotic isolated fractures could be treated safely with functional bracing and early weight bearing. They also recommend the use of weight bearing radiographs in the first outpatient appointment as a reliable method to confirm ankle stability. Their recommendations are in line with the current guidelines.

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751