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Managing an Ankle Fracture

Eli Burke

A Weber B ankle fracture is a specific type of fibular fracture that occurs at the level of the ankle joint, typically involving a transverse fracture line above the level of the syndesmosis. This injury can significantly impact mobility and function, making physiotherapy essential for optimal recovery.


Weber B fractures are characterised by:

  • Anatomy: The fracture line extends above the syndesmosis, involving the fibula, and may or may not involve the medial structures depending on severity.

  • Mechanism: Often caused by rotational forces or external trauma, leading to instability and pain.

  • Treatment: Typically managed with immobilisation, sometimes surgical intervention, followed by rehabilitation to restore function and prevent complications


Initial Physiotherapy Considerations

  1. Post-Injury Assessment:

    • Imaging Confirmation: X-rays or CT scans to confirm the fracture type and assess any associated ligamentous injuries.

    • Pain Management: Initial strategies include rest, ice, elevation, and possibly medication prescribed by a healthcare provider.


  2. Early Rehabilitation Goals:

    • Immobilisation: Utilisation of a cast or brace to protect the fracture site and allow initial healing.

    • Range of Motion (ROM) Exercises: Gentle ankle movements to prevent stiffness and maintain joint mobility.

    • Weight-Bearing Progression: Gradual introduction of weight-bearing as tolerated, ensuring protection of the healing fracture.


Progressive Rehabilitation Phases

  1. Rehabilitation Phase:

    • Strength and Stability Exercises: Targeting muscles around the ankle joint and lower leg to improve stability and support.

    • Proprioception Training: Exercises to enhance balance and proprioceptive awareness, crucial for preventing recurrent injuries.

    • Gait Training: Gradual transition from assisted walking to normal gait patterns, ensuring proper weight distribution and alignment.


  2. Functional Recovery:

    • Sport-Specific Activities: Tailored exercises to simulate activities relevant to daily life or sports participation, gradually increasing in intensity.

    • Endurance Training: Incorporation of cardiovascular exercises to improve overall fitness and endurance levels.


Complication Prevention and Long-Term Management

  1. Education and Monitoring:

    • Patient Education: Guidance on proper footwear, activity modifications, and signs of potential complications (e.g., infection, delayed healing).

    • Follow-Up: Regular follow-up appointments to monitor healing progress and adjust rehabilitation goals as necessary.


Managing a Weber B ankle fracture requires a holistic approach, combining initial immobilisation, progressive rehabilitation, and patient education under the guidance of a physiotherapist. By addressing pain, restoring function, and preventing complications, physiotherapy plays a pivotal role in facilitating a full recovery and returning individuals to their pre-injury level of activity.


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