Ankle Case 11 ED Management

Weber C Fracture

ED Management

When obvious deformity, skin tenting, or neurovascular compromise is present, urgent reduction should be attempted at bedside even prior to obtaining imaging or after a rapidly obtained bedside radiograph. This typically requires parenteral analgesia and possibly sedation. All obvious deformities should be reduced or attempted to be reduced in the ED prior to splinting to achieve as close to anatomic alignment as possible. 

Weber C fractures require operative management with ORIF. In most cases, ED consultation of orthopedics is indicated as many are admitted for inpatient operative repair within 24-48 hours. If orthopedic consult is not available in the ED, proper splinting with a posterior mold splint, strict non-weight bearing precautions, and urgent outpatient orthopedic follow-up (24-48 hours) is acceptable.