A 38 y.o. woman who sp craniopharyngioma resection and is panhypopit twisted her ankle.

What do you need to know about this kind of fracture?

This is a Weber B fracture which crosses the syndesmosis of the ankle. Although is may look insignificant any fracture of the fibular which crosses the syndesmosis requires a stress view. In more than 1/3 of cases the syndesmosis is disrupted and requires a surgical repair. If these fractures are missed they can result in post traumatic osteoarthrosis and permanent disability.

Weber A- the fracture is below the syndesmosis. The fracture is usually stabel

Weber B—the fracture is at the level of the syndemosis and requires a stress view to determine stability

Weber C- the fracture is above the syndesmosis and requires surgery.

Two other fractures of the ankle to be aware of are

Maisonneuve fractures- fractures of the proximal fibula with tibiofibular syndesmosis injury and deltoid ligament injury , with or without medial malleolus fx.

Pilon fracture- fracture of the distal tibia where the talus impacts the tibial plafond. These are high speed injuries generally

Our patient was casted by ortho and is awaiting surgery

Kohake M, Wiebking U, O’Loughlin P, et al. Mid to long term outcomes after Weber B type ankle fractures with and without syndesmotic rupture. In Vivo 2019 Jan-Feb 33(1) 255-261.

Goost H, Wimmer M, Barg A, et al. Fractures of the ankle joint. Investigation and treatment options. Dtsch Arztbi Int 2014 111(21):377-88.

Mollenhoff G, Walz M. Tibial Pilon Fracture Unfall Chirurg. 1998 May 101(5) 395-401.