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A novel remedy for isolated weber B ankle fractures: surgical treatment using a specialized anatomical locking plate

Dong-Il Chun, Ashish Ranjan Sharma, Do Young Kim, Aiymbyek Ulagpan, Supriya Jagga, Sang-Soo Lee, Jaeho Cho

The aims of this study were to present a remedy for isolated Weber type B fractures using a new surgical technique, a specialized anatomical locking plate without inter-fragmentary lag screws, and an early weight-bearing protocol after surgery, as well as to evaluate the outcomes of this remedy. The study included 29 patients (17 males and 12 females; mean age, 40.8 years, range, 18 to 82 years) with a minimum 1-year follow-up period. Surgery was performed as fixation without inter-fragmentary lag screws using a specialized locking plate that was pre-anatomically contoured on the outline of the fibula. Tolerable weight bearing was permitted in the second postoperative week. Fractures were compared clinically and radiologically to the injured side and were rated according to the criteria reported by McLennan and Ungersma. The Foot and Ankle Outcome Score (FAOS) were used to evaluate functional results. In all patients, union was achieved without any loss of reduction or malunion. There were no infections or wound complications. According to the McLennan and Ungersma criteria, all patients were rated good radiologically; however, 2 were rated fair and 27 were good functionally. The mean FAOS score was 90.5 (range 62.4 to 100) at 1 year follow up after surgery. The fixation method without interfragmentary lag screws using a specialized anatomical locking plate and early postoperative weight bearing has the advantages of being an easy procedure with greater stability and provides good functional and radiological outcomes in patients with isolated Weber B ankle fractures.