Weightbearing vs Gravity Stress Radiographs for Stability Evaluation of Supination-External Rotation Fractures of the Ankle

Seidel, Angela; Krause, Fabian; Weber, Martin

doi:10.1177/1071100717702589

Cited by 63 publications

(95 citation statements)

References 32 publications

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“…Despite this unreliability, medial tenderness and bruising remain the only clinical sign of possible instability. Stress radiographs (manual and gravity) are di cult to obtain, poorly tolerated by patients and could lead to over-diagnosis of ankle instability (17,18). Weight bearing radiographs have also been examined for their ability to detect ankle instability.…”

Section: And the British Orthopaedic Association Standards Formentioning

confidence: 99%

Functional bracing is a safe and cost effective treatment for isolated Weber B fracture

Abdelaal

Elnikety

2020

Preprint

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BackgroundDespite the current recommendations that stable Weber B ankle fractures can be treated with functional bracing and weightbearing as tolerated, some reluctance exists among trauma surgeons to follow these recommendations. We report on our institution’s experience in managing these injuries and compare it to the national guidelines.Patients and MethodsConsecutive 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 Molandar score). Method of immobilisation, weightbearing status, radiological fracture union, clinical outcomes and complications were all assessed and analysed.ResultsOne hundred and twenty-three 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. Sixty-two patients were treated in plaster and were 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 weightbearing status during treatment. There was no statistically significant difference in the functional outcome measures between the two groups. The protocol of functional bracing and weightbearing was associated with fewer outpatient clinics and a reduced number of radiographs obtained in the clinic and fewer complications. ConclusionIsolated trans-syndesmotic Weber B ankle fractures, that are clinically and radiologically stable, can be safely treated with functional bracing in a boot and weightbearing as tolerated. Weightbearing radiographs are reliable in confirming the stability of such fractures.

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Section: And the British Orthopaedic Association Standards Formentioning

confidence: 99%

Functional bracing is a safe and cost effective treatment for isolated Weber B fracture

Abdelaal

Elnikety

2020

Preprint

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“…During interpretation, the radiologist must pay attention above all to changes in the bone alignment/ angulation and the width of the articular spaces. 4,[30][31][32][33] Flatfoot (pes planus) is a congenital or acquired deformity of the foot characterized by the collapse of the medial longitudinal arch; in adults, it is most frequently caused by the presence of a posterior tibial tendon dysfunction resulting in planovalgus deformity of the hindfoot. Flatfoot is assessed radiographically as a concave dorsal deviation of the midfoot evaluated on the weight-bearing lateral film, whereas the opposite condition, with dorsal convexity, is termed a cavus foot.…”

Section: Weight-bearing Ankle and Footmentioning

confidence: 99%

“…Weight-bearing imaging has also proved useful in clinical decision making about nonoperative treatment in isolated lateral malleolar fractures of the supination external rotation type, in particular, to evaluate fracture stability. 30,32,33 Hallux valgus is a deformity characterized by the lateral (valgus) deviation of the big toe at the metatarsophalangeal joint with concomitant medial (varus) deviation of the first metatarsal. Preoperative planning requires a weight-bearing (standing) dorsoplantar radiograph of the foot with the beam centered on the midfoot.…”

Section: Weight-bearing Ankle and Footmentioning

confidence: 99%

Weight-bearing MR Imaging of Knee, Ankle and Foot

Bruno

Arrigoni

Palumbo

et al. 2019

Semin Musculoskelet Radiol

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Clinical management of several pathologies of the lower extremity joint relies on instrumental imaging evaluation. The assessment of joint changes with physiologic load requires studies using positions with the patient standing. Weight-bearing radiographs are the mainstay for the evaluation of several conditions such as knee osteoarthritis, pes planus, and hallux valgus, in particular to obtain measurements of articular parameters, especially for presurgical studies. In the last few years, dedicated magnetic resonance imaging and computed tomography scanners have also been developed to obtain high-resolution, multiplanar, and sectional images of the lower extremity joints during weight-bearing. These techniques provide detailed information on joint structure modifications under load in both physiologic and pathologic conditions to improve the diagnostic accuracy of weight-bearing studies.

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“…En los últimos años han surgido diferentes estudios que apuntan a que las radiografías en carga respecto al test de gravedad diagnostican mejor la estabilidad del tobillo tras una fractura bimaleolar SER IV y pueden evitar cirugías innecesarias (9)(10)(11) . Muchas fracturas consideradas SER IV con el test de gravedad son estables y mantienen la mortaja reducida cuando se realizan radiografías en carga.…”

Section: No Se Debe Reparar Test De Cargaunclassified

¿Qué hacer con el ligamento deltoideo?

Busquets-Net¹,

Duarri-Lladó²

2019

MACT

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Este es un artículo Open Access bajo la licencia CC BY-NC-ND (www.creativecommons.org/licenses/by-nc-nd/4.0/). FS Introducción El ligamento deltoideo (LD) es un estabilizador medial del tobillo esencial. Las lesiones del LD pueden presentarse como lesiones degenerativas, como esguinces (bien aisladas o asociadas a lesiones de otros ligamentos como la sindesmosis) o en el contexto de una fractura bimaleolar. En este apartado nos referiremos a los 2 últimos tipos. Como en otras patologías, el tratamiento de las lesiones del LD ha suscitado controversia entre el tratamiento quirúrgico o conservador (1,2) .

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Weightbearing vs Gravity Stress Radiographs for Stability Evaluation of Supination-External Rotation Fractures of the Ankle

Abstract: Level III, prospective comparative study.

Cited by 63 publications

References 32 publications

Functional bracing is a safe and cost effective treatment for isolated Weber B fracture

Functional bracing is a safe and cost effective treatment for isolated Weber B fracture

Weight-bearing MR Imaging of Knee, Ankle and Foot

¿Qué hacer con el ligamento deltoideo?

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