Weight-Bearing Test: A Straightforward and Reliable Indicator of Stability in Supination-External Rotation Type,...

Area of Science:

• Orthopedic Surgery
• Traumatology
• Sports Medicine

Background:

• Supination-external rotation (SER/Weber B) ankle fractures require precise stability assessment.
• Determining the stability of SER type lateral malleolar fractures with potential medial clear space widening presents challenges.
• Existing clinical tests for fracture stability have limitations.

Purpose of the Study:

• To evaluate the weight-bearing (WB) test as a simple and predictable method for assessing SER/Weber B ankle fracture stability.
• To report the outcomes of nonoperative treatment for SER/Weber B lateral malleolar fractures managed based on the WB test.

Main Methods:

• The WB test was used to assess fracture stability in SER/Weber B lateral malleolar fractures without definite medial clear space widening.
• Patients able to walk at least 4 steps unaided were considered stable and received nonoperative treatment.
• Radiographic parameters, VAS pain scores, and AOFAS scores were analyzed in 68 patients followed for over 6 months.

Main Results:

• All 68 patients achieved radiographic union with maintained joint congruency.
• The average Visual Analog Scale (VAS) pain score was 1.03, and the mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 87.34.
• All patients successfully returned to their pre-injury activity levels.

Conclusions:

• The WB test is a simple and reliable clinical indicator for identifying stable SER/Weber B lateral malleolar fractures.
• Nonoperative management based on the WB test yields good radiographic and clinical outcomes.
• This approach simplifies treatment decisions for SER/Weber B ankle fractures.