Haaglanden Medical Center (Trauma Unit), The Hague, The Netherlands.
Eur J Trauma Emerg Surg. 2024 Aug;50(4):1521-1526. doi: 10.1007/s00068-024-02474-2. Epub 2024 Mar 2.
Weight-bearing (WB) radiographs are commonly used to judge stability of type B fibula fractures and guide the choice of treatment. Stable fractures can be treated conservatively, and unstable fractures surgically. The question is raised how much weight patients actually put on their broken ankle while making a WB radiograph. The current study will give insight in the actual amount of WB in WB radiographs.
In this retrospective cohort study, 57 patients with a type B fibula fracture with a medial clear space (MCS) < 6 mm on regular mortise (RM) view who underwent a WB radiograph were included. We designed a ramp with a scale in the plateau where the radiographs were taken. Total body weight (TBW) and amount of WB on the fractured limb were measured.
The mean WB on the fractured limb was 49 (13-110) kg and the mean TBW was 79 (45-128) kg, calculating a mean percentage of WB of 63. The mean MCS on the RM radiograph was 3.0 mm, compared to 2.9 mm on the WB radiograph. The mean superior clear space (SCS) was 3.2 mm on the RM view, compared to 3.2 mm on the WB radiograph as well. The average fibular dislocation was 1.5 mm on the RM radiograph, compared to 1.6 mm on the WB radiograph.
There is a big variability in the amount of weight-bearing on the ankle when a WB radiograph is made. This is important to keep in mind when assessing the radiographs and deciding on the treatment course.
负重（WB）射线照相通常用于判断 B 型腓骨骨折的稳定性并指导治疗选择。稳定的骨折可以保守治疗，不稳定的骨折则需要手术治疗。问题是，在拍摄 WB 射线照相时，患者实际上在他们骨折的脚踝上施加了多少重量。目前的研究将深入了解 WB 射线照相中的实际 WB 量。
在这项回顾性队列研究中，纳入了 57 名内侧间隙（MCS）<6 毫米的 B 型腓骨骨折患者，这些患者接受了常规踝穴（RM）视图的 WB 射线照相。我们在拍摄射线照相的平台上设计了一个带有刻度的斜坡。测量总体重（TBW）和骨折肢体的 WB 量。
骨折肢体的平均 WB 为 49（13-110）kg，平均 TBW 为 79（45-128）kg，计算出平均 WB 百分比为 63。RM 射线照相上的平均 MCS 为 3.0 毫米，而 WB 射线照相上为 2.9 毫米。RM 视图上的平均上间隙（SCS）为 3.2 毫米，与 WB 射线照相上的 3.2 毫米相同。RM 射线照相上的腓骨平均脱位为 1.5 毫米，与 WB 射线照相上的 1.6 毫米相似。
在拍摄 WB 射线照相时，脚踝的负重量有很大的差异。在评估射线照相并决定治疗方案时，这一点很重要。
