![]() ![]() Typically requires operative managementĭistal tibial physeal fractures are classified by the Salter-Harris classification. Tillaux and triplane fracture 2 mm displacement If treated operatively, to be arranged by orthopaedic service If treated with closed reduction, fracture clinic within 5 days If reduction not anatomic, discuss with orthopaedic on call serviceįor Salter-Harris type III and IV, refer to orthopaedic on call service Immobilise in above-knee cast, non-weight bearingįor Salter-Harris type III and IV, discuss with orthopaedic on call service whether CT scan is required to confirm that fracture is truly undisplacedĬlosed reduction with above-knee cast, non-weight bearing. Isolated undisplaced distal fibula physeal - Salter-Harris type I and IIįracture clinic within 7-10 days with x-ray What are the potential complications associated with this injury?.What is the usual ED management for this injury?.Do I need to refer to orthopaedics now?.When is reduction (non-operative and operative) required?.What radiological investigations should be ordered?.How common are they and how do they occur?.See also: Distal tibia and or fibular physeal fracture 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. This classification was first described by the Belgian general surgeon, Robert Danis (1880-1962), in 1949. 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) 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 Below the level of the syndesmosis (infrasyndesmotic)
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