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Comparative Study
. 2025 Jul 7;51(1):249.
doi: 10.1007/s00068-025-02928-1.

Lag screw versus no lag screw in surgery for Weber B ankle fractures: impact on recovery and surgical outcomes

Wouter J Joosten  1 , Margot H M Heijmans  2 , William A van Dijk  1 , Coen C M M Jaspars  3 , Percy V van Eerten  1
Affiliations
Comparative Study

Lag screw versus no lag screw in surgery for Weber B ankle fractures: impact on recovery and surgical outcomes

Wouter J Joosten et al. Eur J Trauma Emerg Surg. .

Abstract

Purpose: A lag screw is not always used in treating unstable Weber B ankle fractures, and evidence supporting its necessity remains limited. Therefore, recovery and surgical outcomes will be compared between surgery with and without a lag screw in patients with a Weber B ankle fracture.

Methods: A retrospective cohort study was conducted, including patients with a Weber B fracture who underwent surgery at Máxima Medical Center between 2012 and 2022. Surgery duration, complications, recovery, and reoperation rate and reasons were compared between patients treated with and without a lag screw. A questionnaire, including the Foot and Ankle Outcome Score, was sent to the same cohort to assess current ankle functionality and treatment satisfaction.

Results: A total of 302 patients were included, of which 194 with a lag screw. The overall complication rate did not differ (p=0.87), while the distribution of complications did (p=0.01). More wound complications were observed in the no lag screw group (14.8% vs 9.3%), whereas less nerve injuries (0.0% vs 4.6%) and implant complaints (0.9% vs 3.1%) were observed. Surgery duration, recovery, reoperation rate and reasons did not differ between the groups. The questionnaire was completed by 141 patients, of which 92 with a lag screw. Foot and Ankle Outcome subscale scores and treatment satisfaction did not differ between the groups.

Conclusion: This study demonstrates that the use of a lag screw is not essential in treating Weber B ankle fractures, as no differences in recovery and surgical outcomes were found between the two groups.

Keywords: Ankle fracture; Foot and Ankle Outcome Score (FAOS); Lag screw; Open reduction and internal fixation (ORIF); Surgery; Weber B.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the retrospective data collection and the additional questionnaire study
Fig. 2
Fig. 2
Foot and Ankle Outcome Scores per subscale per group
Fig. 3
Fig. 3
Outcome per group for the question ‘Are you currently satisfied with the recovery of your foot/ankle?’
See this image and copyright information in PMC

References

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