Are Stress Tests Needed for Ankle Fracture.

Marc Swiontkowski

MD, FAOA

Professor, University of Minnesota

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Mohit Bhandari

FRCSC, PhD

Distinguished University Professor, Chair of Surgery, McMaster University

The discussion examines whether gravity stress tests meaningfully guide management of Weber B ankle fractures. Drawing on a Norwegian cohort of 149 patients treated non-operatively regardless of stress test result, the hosts highlight that outcomes at two years were equivalent between “stable” and “partially unstable” groups. They situate this finding within decades of mixed observational data and an ongoing debate about deltoid integrity, noting that clinical signs may be more informative than isolated stress radiographs. Ultimately, the episode argues that early weightbearing with close follow-up may be sufficient, while calling for a large prognostic cohort and subsequent randomized trial to definitively clarify the value of stress testing.