Talar shift or widening of the mortice indicates instability.įractures below the syndesmosis (Weber A avulsion type injuries) without associated medial ankle #/tenderness can be treated in a walking/CAM boot and may mobilise WBAT. Fractures distal to the syndesmosis are unlikely to be associated with ligamentous injury and therefore likely to be stable.įibula fractures that are associated with medial fractures or medial ligamentous injury are likely to be unstable despite normal alignment on x-ray. The stability of a fibula fracture determines treatment. Open wounds should be cleaned and dressed in a sterile manner.Fracture dislocations should be reduced.Site of tenderness (palpate entire length of fibula).The skin should be assessed for any open injuries and the amount of soft tissues swelling.ĭislocations should be reduced and casted immediately. Neurovascular status should be carefully examined. From weight bearing with an antalgic gait to non-weight bearing with significant pain, swelling, discomfort and varying deformity. This type of injury includes Maisonneuve injuries.īased on foot position at time of injury and the force applied through the foot. Causes disruption of the syndesmosis and is usually associated with medial ankle injuries. Weber C - a fracture above the level of the syndesmosis. May be associated with medial ankle injury/fracture or posterior malleolus fractures. Mechanism is external rotation of the foot. Weber B - a fracture at or near the level of the syndesmosis. Weber A - a fibular fracture below the level of the syndesmosis. Higher risk of syndesmotic disruption and instability is associated with more proximal fractures. Orthopaedic review either in ED or within 1-3 days.īased on the position of the fibular fracture. Reduction if required, short leg backslab, NWBĭisplaced/>25% of articular surface: short leg backslab, NWB Talar shift or medial malleolar fracture: reduction, short leg backslab Orthopaedic follow-up in ED or within 1-2 daysįibula fracture above syndesmosis (Weber C)Īnkle in normal anatomical position: short leg backslab NWB Weber B, displaced: short leg backslab, NWB The shape of the talus and calcaneus and the architecture within the calcaneus, especially the arrangement of the trabeculae, are essential factors for calcaneal fractures.Weber B, undisplaced: short leg backslab NWB The fracture maps showed fracture patterns and recurrent fracture zones on all calcaneal surfaces. All fracture locations coincided with the interfaces between the trabecular groups. On the posterior surface, the fracture lines appeared to be centered superiorly. Vertical fracture lines dominated the anterior calcaneal fracture map. Three dense bands of fractures were observed on the medial surface, and four fracture bands were observed lateral to the calcaneus. There were four concentrated bands of fracture lines and two fracture hot spots on the superior surface. The stacked images of six calcaneus surfaces were also converted into spectrograms with MATLAB to highlight the fracture frequency at specific locations. Fracture lines were copied from a reduced 3D calcaneal fracture model and stacked on calcaneal templates to generate fracture maps. This goal was achieved by fracture maps created by copying and stacking fracture lines as viewed from six surfaces of the calcaneus.Ī total of 210 consecutive patients with 226 calcaneal fractures were retrospectively analyzed. This study aimed to investigate the relationship between the distribution of calcaneal fracture lines and their determinants, especially those related to the internal structure of the calcaneus. Therefore, in-depth research into the underlying mechanism of calcaneal fracture is still of great interest, with the goal of improving treatment for patients suffering from this condition. Calcaneal fractures are associated with numerous complications and a poor prognosis with significant long-term quality-of-life issues, regardless of treatment.
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