title: A Novel Algorithm for Isolated Weber B Ankle Fractures: A Retrospective Review of 51 Nonsurgically Treated Patients.
abstract: BACKGROUND
  Stability of isolated Weber B ankle fractures can be difficult to determine. Using weight-bearing radiographs, a reliable method to determine the stability of isolated Weber B ankle fractures is described.
  
  
  METHODS
  A retrospective review of prospectively gathered data was performed. Weber B ankle fractures were defined as stable when having a medial clear space (MCS) of <7 mm on initial gravity stress radiographs and a normal mortise relationship on weight-bearing radiographs. Fifty-one patients meeting these criteria were treated nonsurgically with protected weight bearing and serial radiography for 1 year.
  
  
  RESULTS
  Average functional score results were: American Orthopaedic Foot and Ankle Society Hindfoot, 93.2; Foot and Ankle Ability Measure for Activities of Daily Living, 93.2; Olerud-Molander Ankle Score, 91.0; and visual analog scale pain score, 0.57. Despite a mean gravity stress MCS of 4.42 mm, no patient demonstrated subsequent MCS widening. Mean MCS on 1-year follow-up weight-bearing radiographs was 2.64 mm.
  
  
  CONCLUSIONS
  Weight-bearing ankle radiographs are predictive of stability in isolated Weber B ankle fractures. Gravity stress radiographs using traditional measurement criteria may overestimate instability in these injuries. Nonsurgical treatment with protected weight bearing shows good early outcomes.
  
  
  METHODS
  IV.
authors: From the University of Michigan, Ann Arbor, MI (Dr. Holmes, Dr. Acker, Ms. McKinney, and Dr. Irwin), Reconstructive Orthopaedics and Sports Medicine, Cincinnati, OH (Dr. Murphy), and Northwestern University Feinberg School of Medicine, Chicago, IL (Dr. Kadakia).
authors: James R
authors: JR
authors: Holmes
authors: William B
authors: WB
authors: Acker
authors: Joshua M
authors: JM
authors: Murphy
authors: Amy
authors: A
authors: McKinney
authors: Anish R
authors: AR
authors: Kadakia
authors: Todd A
authors: TA
authors: Irwin
mesh_terms: D000328:Adult; D000465:Algorithms; D064386:Ankle Fractures / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000843:Ankle Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D011446:Prospective Studies; D011859:Radiography / Q000379:methods*; D012189:Retrospective Studies; D016474:Weight-Bearing