What is the management approach for Type C ankle fractures in the Weber classification?

Type C ankle fractures, as classified by the Weber system, involve fractures of the fibula above the level of the syndesmosis and are associated with deltoid ligament damage or syndesmotic injury. These fractures typically indicate significant instability and often occur alongside ligamentous injuries that compromise the integrity of the ankle joint.

The management of Type C ankle fractures is predominantly surgical. The rationale for surgical intervention includes the need to restore the anatomical alignment and stability of the ankle joint, which is crucial for proper function. This often involves the use of plates and screws to stabilize the fracture fragments, allowing for early mobilization and a reduced risk of complications such as malunion or post-traumatic arthritis.

Conservative treatment and the application of a below-knee cast are not adequate for Type C fractures due to their instability. Such approaches may lead to improper healing and poor long-term outcomes. Similarly, while evacuation of hemarthrosis may be necessary in certain situations, it does not address the underlying instability that characterizes Type C fractures. Thus, surgical repair is the recognized and appropriate management approach for these injuries, focusing on restoring both the skeletal structure and the associated soft tissue integrity.