Steven M Hadley, John J Peabody, Rachel Bergman, Sarah J Westvold, Eric H Durudogan, Frederic Washburn, Shaun Chang, Muhammad Y Mutawakkil, Milap Patel, Anish R Kadakia
{"title":"Weber Classification Does Not Correlate with PROMIS Outcome Measures.","authors":"Steven M Hadley, John J Peabody, Rachel Bergman, Sarah J Westvold, Eric H Durudogan, Frederic Washburn, Shaun Chang, Muhammad Y Mutawakkil, Milap Patel, Anish R Kadakia","doi":"10.1177/24730114261469561","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>It remains unclear whether Weber subtype correlates with outcomes measured by validated Patient Reported Outcomes Measurement Information System (PROMIS) following ankle fracture surgery. We examine whether Weber subtype correlates with PROMIS.</p><p><strong>Methods: </strong>This was a retrospective review of 527 patients who underwent ankle fracture surgery at a single institution (2016-2021). Two fellowship-trained orthopaedic surgeons independently reviewed all radiographs. Of the 527 who were included in final analysis evaluating complications, 182 with Weber B and Weber C fractures completed PROMIS physical function (PF) and pain interference (PI) measures. All 182 had anatomically reduced ankles and were included for analysis of PROMIS. Primary outcome was PROMIS.</p><p><strong>Results: </strong>Among survey responders (n = 182), no significant difference existed between Weber B and Weber C anatomically reduced in mean PF (52.3 ± 9.9 vs 53.5 ± 9.2, <i>P</i> = .47) and PI (48.4 ± 8.8 vs 47.0 ± 7.7, <i>P</i> = .34). In adjusted-regression, Weber B and Weber C were not significantly different for mean PF (53.8 vs 53.9, <i>P</i> = .92) or PI (48.0 vs 46.4, <i>P</i> = .27). Body mass indexes (BMIs) of 30 or greater had worse mean PF (<i>P</i> = .04) and PI (<i>P</i> < .01). Compared with males, females had worse mean PF (<i>P</i> < .001) and PI (<i>P</i> < .01). Older patients had lower PF compared to younger (<i>P</i> = .01). In overall cohort (n = 527), Weber C radiographic complication rate was 32.3% (41/127) vs 11.5% (46/400) Weber B (<i>P</i> < .001), with higher syndesmotic loss of reduction and early-onset degenerative joint disease (DJD) rates (9.4% vs 1%, <i>P</i> < .001; 11.8% vs 2.5%, <i>P</i> < .001, respectively). Weber C was 3.52 times (95% CI: 2.08-5.98) as likely to have radiographic complication as Weber B.</p><p><strong>Conclusion: </strong>Patients with anatomically reduced ankles may achieve population mean PROMIS regardless of Weber subtype. Although at early follow-up Weber C fractures have higher radiographic complication rates, including early-onset DJD, proper reduction and stabilization may be especially important to help patients achieve equivalent functional outcomes to patients with Weber B fractures. Higher BMI, female sex, and older age may negatively affect outcomes.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261469561"},"PeriodicalIF":0.0000,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494319/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Foot & Ankle Orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/24730114261469561","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/7/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: It remains unclear whether Weber subtype correlates with outcomes measured by validated Patient Reported Outcomes Measurement Information System (PROMIS) following ankle fracture surgery. We examine whether Weber subtype correlates with PROMIS.
Methods: This was a retrospective review of 527 patients who underwent ankle fracture surgery at a single institution (2016-2021). Two fellowship-trained orthopaedic surgeons independently reviewed all radiographs. Of the 527 who were included in final analysis evaluating complications, 182 with Weber B and Weber C fractures completed PROMIS physical function (PF) and pain interference (PI) measures. All 182 had anatomically reduced ankles and were included for analysis of PROMIS. Primary outcome was PROMIS.
Results: Among survey responders (n = 182), no significant difference existed between Weber B and Weber C anatomically reduced in mean PF (52.3 ± 9.9 vs 53.5 ± 9.2, P = .47) and PI (48.4 ± 8.8 vs 47.0 ± 7.7, P = .34). In adjusted-regression, Weber B and Weber C were not significantly different for mean PF (53.8 vs 53.9, P = .92) or PI (48.0 vs 46.4, P = .27). Body mass indexes (BMIs) of 30 or greater had worse mean PF (P = .04) and PI (P < .01). Compared with males, females had worse mean PF (P < .001) and PI (P < .01). Older patients had lower PF compared to younger (P = .01). In overall cohort (n = 527), Weber C radiographic complication rate was 32.3% (41/127) vs 11.5% (46/400) Weber B (P < .001), with higher syndesmotic loss of reduction and early-onset degenerative joint disease (DJD) rates (9.4% vs 1%, P < .001; 11.8% vs 2.5%, P < .001, respectively). Weber C was 3.52 times (95% CI: 2.08-5.98) as likely to have radiographic complication as Weber B.
Conclusion: Patients with anatomically reduced ankles may achieve population mean PROMIS regardless of Weber subtype. Although at early follow-up Weber C fractures have higher radiographic complication rates, including early-onset DJD, proper reduction and stabilization may be especially important to help patients achieve equivalent functional outcomes to patients with Weber B fractures. Higher BMI, female sex, and older age may negatively affect outcomes.
Level of evidence: Level III, retrospective comparative study.
背景：目前尚不清楚Weber亚型是否与踝关节骨折术后患者报告结果测量信息系统（PROMIS）测量的结果相关。我们研究Weber亚型是否与PROMIS相关。方法：回顾性分析2016-2021年在同一医院接受踝关节骨折手术的527例患者。两名接受过奖学金培训的骨科医生独立审查了所有的x光片。在527例最终分析评估并发症的患者中，182例Weber B型和Weber C型骨折患者完成了PROMIS物理功能（PF）和疼痛干扰（PI）测量。所有182例踝关节解剖复位，纳入PROMIS分析。主要结局是预后。结果：在182名应答者中，Weber B型与Weber C型的平均PF解剖降低无显著差异(52.3±9.9 vs 53.5±9.2,P =；47)和PI（48.4±8.8 vs 47.0±7.7,P = 0.34）。在调整回归中，Weber B和Weber C的平均PF没有显著差异(53.8 vs 53.9, P =。92)或PI （48.0 vs 46.4, P = 0.27）。体重指数(bmi)≥30时，平均PF （P = 0.04）和PI （P P P = 0.01）较差。在整个队列（n = 527）中，Weber C x线片并发症发生率为32.3%(41/127)，而Weber B x线片并发症发生率为11.5%（46/400）。结论：无论Weber亚型如何，解剖性踝关节复位患者均可达到人群平均PROMIS。尽管在早期随访中，Weber C型骨折有较高的影像学并发症发生率，包括早发性DJD，但适当复位和稳定对于帮助患者获得与Weber B型骨折相同的功能结果尤为重要。较高的身体质量指数、女性和年龄较大可能会对结果产生负面影响。证据等级：III级，回顾性比较研究。
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