Patient: Mark. 54-year-old delivery driver
Injury Type: Weber A fracture – distal fibular fracture below the syndesmosis
Date of Injury: 6 months ago
Mechanism of Injury
Mark sustained his injury while stepping down from the tray of his work truck at a Brisbane loading dock. His left foot landed awkwardly on uneven ground, causing his ankle to roll inward with a sudden “pop” and immediate pain on the outside of his ankle. Mark lives locally in Indooroopilly, so he immediately called Access Ortho Indooroopilly and was able to make an appointment within an hour.
Initial Symptoms and Presentation
Mark reported:
- Sharp pain along the lateral side of his left ankle
- Difficulty bearing weight
- Moderate swelling and developing bruising
- No visible deformity or skin compromise
A clinical examination revealed point tenderness over the distal fibula, with no signs of medial pain or joint instability. His ankle was neurovascularly intact.
Diagnosis and Imaging
Mark was sent to Lumus Radiology, located next door to the Access Ortho clinic, for non-weight-bearing X-rays (AP, lateral, and mortise views). The X-rays showed a non-displaced transverse fracture of the distal fibula, consistent with a Weber A fracture. The ankle mortise was preserved, and there was no involvement of the tibia or syndesmosis.
The fracture was assessed to be stable, and a conservative management pathway was initiated per Access Ortho protocols.
Treatment and Follow-Up
Initial appointment
Mark was fitted with a moon boot to be worn full-time except for short periods for showering. He was advised to weight bear as tolerated, and prescribed paracetamol and NSAIDs to manage swelling and discomfort.
Follow-up appointments.
At two weeks, Mark returned to the clinic to see the orthopaedic surgeon. Repeat weight-bearing X-rays were performed to ensure the fracture alignment had been maintained. Radiographs showed progressive healing with no displacement, and Mark reported significantly reduced pain.
Under guidance, he gradually increased his weight-bearing and mobility. At his 6-week review, the boot was removed during the day, and light physiotherapy commenced to restore range of motion.
Rehabilitation and Recovery
From weeks 6–12, Mark worked on strengthening and balance exercises with his physiotherapist. The physio focused on peroneal and calf strengthening, ankle proprioception, and corrected gait abnormalities. Mark’s swelling decreased steadily, and he gradually progressed from light duties at work into a more active role.
Outcome at 6 Months
At 6 months post-injury, Mark has:
- Full, pain-free range of motion
- Returned to full duties at work
- No swelling or instability
- No complications such as chronic pain or stiffness
He reports occasional mild soreness after long days on his feet but no functional limitations. He was discharged from orthopaedic follow-up with no further imaging required.
Reflections
Mark’s case highlights the effectiveness of seeking early assessment. With immediate care, timely imaging, structured follow-up, and progressive rehabilitation, Mark achieved full functional recovery without surgical intervention.
As the injury occurred at work, Mark submitted a Workcover claim with the help of Acccess Ortho. Therefore, Workcover paid for all appointments at Access Ortho and the physio.