Patient reported outcomes following non-operatively managed Weber Type A distal fibula fractures

The outcomes of "Weber A" type fibula fractures treated non-operatively are not well studied. The aims of this study were to investigate patient reported outcomes (PROMs) from such injuries and investigate if different radiological features of the fracture affects such outcomes.

Patients with conservatively managed Weber A fractures were contacted retrospectively (minimum 11 months) to measure PROMs. PROMs included the use of the Chertsey Outcome Score for Trauma (COST) as well as the time to return to work, physical activity and time to become symptom free. The effect of fracture features such as fracture height and intra-articular extension were analysed for their effect on PROMs.

Data was collected from 72 patients from a total of 211 patients presenting with Weber A fractures. The mean COST scores were 83 (range 30-100). Patients reported on average 3.1 weeks (desk based) and 5.7 weeks (labour intensive) to return to work, 10.8 weeks to return to physical activity and 14.8 weeks to become symptom free with 21% of patients still symptomatic at follow-up. Fracture height and fractures with comminution, displacement, intra-articular extension did not appear to be associated with poorer PROMs.

The outcomes are generally excellent; however, most patients do not return to their baseline before the injury, with a significant proportion of patients remaining symptomatic at follow-up. The reported times to return to work, physical activity and symptom-free are useful to manage patient expectations. Our results dispel any assumption that Weber A type distal fibula fractures are always associated with excellent outcomes.