Surgical approach to Weber B ankle fractures

  1. Home
  2. Regional Basic Science
  3. Surgical approach to Weber B ankle fractures
Previous
Next

QUESTION 1 OF 2

A patient is brought into the emergency department after sustaining an ankle injury whilst playing basketball. The ankle is grossly swollen and tender. Radiographs show a pronation external rotation injury pattern. Which answer best describes the sequence of injury?

QUESTION ID: 51

1. A. ATFL disruption, oblique fibula fracture at the level of the syndesmosis, PITFL disruption or posterior malleolus fracture, transverse medial malleolus fracture or deltoid ligament injury.
2. B. Medial malleolus transverse fracture or deltoid disruption, ATFL disruption, lateral short oblique fracture/ spiral fracture of fibula above the syndesmosis, PITFL avulsion or posterior malleolus fracture
3. C. Medial malleolus transverse fracture or deltoid disruption, ATFL disruption, lateral short oblique/ spiral fracture of fibula below the syndesmosis, PITFL avulsion or posterior malleolus fracture
4. D. Medial malleolus transverse fracture or deltoid disruption, ATFL disruption, transverse or comminuted fibula fracture above the level of the syndesmosis.
5. E. Vertical medial malleolus fracture, ATFL disruption or fibula fracture below the joint line
Submit Response

QUESTION 2 OF 2

A 35-year-old scaffolder carrying a heavy weight steps into a shallow pit and twists his ankle sustaining a tri-malleolar fracture of his ankle. He has a Weber B fibular, medial malleolus and posterior malleolus fracture. The posterior malleolus involves approximately 40% of the articular surface.
What is the best management option for him to allow early weight bearing?

QUESTION ID: 1082

1. A. CT scan of the ankle followed by open reduction and internal fixation of the posterior malleolus with a buttress plate and fibula plating (posterolateral approach) and medial malleolus fixation with cannulated screws (medial approach) +/- syndesmosis stabilisation
2. B. CT scan of the ankle followed by open reduction and internal fixation of the fibula (lateral approach) followed by fixation of the medial malleolus (medial approach)
3. C. Open reduction and internal fixation of the fibula (lateral approach) followed by fixation of the medial malleolus (medial approach) +/- Syndesmosis stabilisation
4. D. Open reduction and internal fixation of the fibula (lateral approach) followed by fixation of the medial malleolus (medial approach) followed by Anterior to posterior screws of the posterior malleolus +/- syndesmosis stabilisation
5. E. Spanning external fixation of the ankle joint with 5MM pins to his tibia, calcaneum and 4MM to the first metatarsal.
Submit Response