title: Misdiagnosis of OTA type B (Weber B) ankle fractures leading to nonunion.
abstract: Little is known about the specific etiology of nonunion of stable Orthopaedic Trauma Association (OTA) type B fractures. In the present retrospective cohort study, we investigated all patients with a nonunion in a level 1 trauma center during an 8.5-year period. Patient history, clinical findings, radiographic features, and therapeutic aspects were critically evaluated to be able to predict the nonunion. In the predefined period, 388 patients were treated for a stable OTA type B fracture. Eight patients (2.1%) developed a nonunion. Retrospectively, the radiographic features in 6 of the 8 patients and clinical findings in 1 of the 8 patients could predict the nonunion. We conclude that in almost every nonunion occurring after a "stable" OTA type B fracture in the present study were, in fact, originally unstable fractures.
authors.affiliation: Department of Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. c.donken@chir.umcn.nl
authors.forename: Christian C M A
authors.initials: CC
authors.lastname: Donken
authors.forename: Cees J H M
authors.initials: CJ
authors.lastname: van Laarhoven
authors.forename: M J
authors.initials: MJ
authors.lastname: Edwards
authors.forename: Michiel H J
authors.initials: MH
authors.lastname: Verhofstad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000175:diagnosis* / Q000601:surgery; D003951:Diagnostic Errors; D005260:Female; D005360:Fibula / Q000293:injuries; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D005599:Fractures, Ununited / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015599:Trauma Severity Indices; D055815:Young Adult