Midterm Follow-up of a Novel Algorithm for Nonoperative Weber B Ankle Fractures

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Background:

• Stable Weber B ankle fractures are typically managed nonoperatively.
• A novel algorithm was previously developed to guide nonoperative treatment selection.
• This study assesses the long-term durability of this nonoperative approach.

Purpose of the Study:

• To evaluate the durability of nonoperative treatment for stable Weber B ankle fractures.
• To assess functional outcomes and radiographic evidence of arthritis at minimum 5-year follow-up.

Main Methods:

• 51 patients from an initial study were contacted for follow-up.
• Functional scores (AOFAS, OMA, VAS) and ankle radiographs were collected.
• Radiographs were assessed for ankle arthritis using the Kellgren-Lawrence grading scale.

Main Results:

• 29 patients (56%) completed follow-up at an average of 6.8 years.
• High functional scores were maintained: AOFAS 98.43, OMA 94.11, VAS 0.46.
• AOFAS scores improved significantly from 1 to 5 years (P=.002); OMA and VAS scores remained stable. All fractures achieved union.

Conclusions:

• The nonoperative algorithm for selected Weber B ankle fractures demonstrates durable results.
• Medial clear space widening up to 7 mm on weight-bearing radiographs supports nonoperative management.
• This reinforces the efficacy of the established algorithm for conservative fracture care.