![]() ![]() However, this study suggests that fractures in the zones labelled in the diagram "stress fractures" and "true Jones" fractures may not be clinically distinct groups. The proximal extent of a fracture for inclusion is not very clear in this study, and their definitions are not exactly those of Lawrence and Botte. CT can further define the fracture pattern and assess for tendon subluxation. associated fractures of the fibula can be evident, with or without ankle dislocation. 37 patients were operated on primarily, mainly because they were athletes. by definition, the fracture involves the tibial plafond and the distal tibial articular surface. It is difficult to interpret this study for a number of reasons. 4/25 fractures that were initially treated non-surgically failed to unite. Just over half the patients were athletes. There were no differences in the epidemiology, outcomes or adverse events between these groups. fractures that did not extend beyond the joint.fractures that extended beyond the 4th/5th intermetatarsal joint.The examined two possibly distinct groups: Chuckpaiwong (2008) analysed 61 proximal metaphyseal/diaphyseal junction fractures. Others (Lawrence + Botte 1993) separate a group in which the fracture line is at the level of the 4th-5th intermetatarsal joint, calling these "true Jones fractures". Some authors classify all fractures proximal to this zone together. ![]() There is definitely a region just distal to the tuberosity in which fractures are more likely to go on to non-union, probably as a result of the stress riser effect and possibly the vascular watershed. Using the Dameron-Lawrence-Bofte classification it was found that 73.6 were Zone 1, 22.2 were Zone 2 and 4.2 were Zone 3. There is some controversy as to the best sub-classification of this zone. Results: Out of the 270 patients that presented to the Virtual Fracture Clinic with fifth metatarsal fractures, 53.3 were basal fractures of the fifth metatarsal. Fractures of the proximal metatarsal are often referred to as "Jones fractures". Fractures of the Ankle Joint: Investigation and Treatment Options. Goost H, Wimmer M, Barg A, Kabir K, Valderrabano V, Burger C. Fracture of the fifth metatarsal’s base is one of the most common stress fractures encountered in the lower extremities 14.The fracture is characterized by a transverse disruption at the diaphyseal and metaphyseal junction of the proximal 1/3 rd of the metatarsal bone. Lawrence and Botte classify proximal fifth metatarsal fractures according to their location: tuberosity avulsion fractures (zone 1), fractures at metaphyseal-diaphyseal junction extending into the fourth-fifth intermetatarsal joint (zone 2) and proximal diaphyseal fractures (zone 3). ![]() Evaluation of the Syndesmotic-Only Fixation for Weber-C Ankle Fractures with Syndesmotic Injury. CURRENT Diagnosis & Treatment in Orthopedics, Fourth Edition. Musculoskeletal Eponyms: Who Are Those Guys? Radiographics. Usually associated with an injury to the medial side ![]() Weber C fractures can be further subclassified as 6Ĭ1: diaphyseal fracture of the fibula, simpleĬ2: diaphyseal fracture of the fibula, complexĪ fracture above the syndesmosis results from external rotation or abduction forces that also disrupt the joint Medial malleolus fracture or deltoid ligament injury often presentįracture may arise as proximally as the level of fibular neck and not visualized on ankle films, requiring knee or full-length tibia-fibula radiographs ( Maisonneuve fracture) Tibiofibular syndesmosis disruption with widening of the distal tibiofibular articulation Weber B fractures could be further subclassified as 9ī2: associated with a medial lesion (malleolus or ligament)ī3: associated with a medial lesion and fracture of posterolateral tibiaĪbove the level of the syndesmosis (suprasyndesmotic) Variable stability, dependent on the status of medial structures (malleolus/ deltoid ligament) and syndesmosis may require open reduction and internal fixation (ORIF) Tibiofibular syndesmosis usually intact, but widening of the distal tibiofibular joint (especially on stressed views) indicates syndesmotic injuryĭeltoid ligament may be torn, indicated by widening of the space between the medial malleolus and talar dome Usually stable if medial malleolus intact treat with CAM Walker or Moon Boot with crutches and weight bear as tolerated with them for 6 weeksĭistal extent at the level of the syndesmosis (trans-syndesmotic) may extend some distance proximally Below the level of the syndesmosis (infrasyndesmotic) ![]()
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