Please see the picture below to understand where this injury is. The height of the fibular lesion is directly connected to the condition of the syndesmosis, regardless of whether there is a medial ankle injury, and of what type this may be. If your injury is classified as a stable Weber B type fracture, you will be treated in a boot. Weber BG, 1972: 51-63 Weber on the syndesmosis Malleolar fractures with Fibular lesion proximal to the syndesmosis Malleolar fractures with Fibular lesion at the height of the syndesmosisĬ. Malleolar fractures with Fibular lesion distal to the syndesmosisī. The pathology in the area of the Fibula – syndesmosis is the centre of interest, and we arrive at the following classification of injuries to the upper ankle joint:Ī. Then, in a slightly modified form and a different representation, we also subdivide the ankle injuries.įor the classification we suggest that the X-ray should orientate us to the pathological-anatomical lesion at a single glance, whereby it does not interest us primarily how the respective injury came about. DANIS (1948) recommends his purely pathological-anatomical classification. 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. Code Code Tree Want to read the entire topic Access the full ICD-10 Coding Guide for 9. Fracture clinic within 7-10 days with x-ray. Code S82.64XA - Nondisplaced fracture of lateral malleolus of right fibula initial encounter for closed fracture Billable Theres more to see - the rest of this topic is available only to subscribers. doi:10.1148/radiographics.20.3.g00ma20819 - Pubmed Isolated undisplaced distal fibula physeal - Salter-Harris type I and II. Musculoskeletal Eponyms: Who Are Those Guys? Radiographics. 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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