Weber classification of ankle fractures

The Weber ankle fracture classification (sometimes Danis-Weber) is a simple system for classification of lateral malleolar fractures, relating to the level of the fracture in relation to the ankle joint. It has a role in determining treatment. 

Classification

  • type A
  • type B
    • distal extent at the level of the talar dome; may extend some distance proximally
    • usually spiral 
    • tibiofibular syndesmosis usually intact, but widening of the distal tibiofibular joint (especially on stressed views) indicates syndesmotic injury
    • medial malleolus may be fractured
    • deltoid ligament may be torn, indicated by widening of the space between the medial malleolus and talar dome
    • variable stability, dependent on status of medial structures (malleolus/deltoid ligament) and syndesmosis;  may require ORIF
    • Weber B fractures could be further subclassified as 9
      • B1: isolated
      • B2: associated with a medial lesion (malleolus or ligament) 
      • B3: associated with a medial lesion and fracture of posterolateral tibia 
  • type C
    • above the level of the ankle joint
    • tibiofibular syndesmosis disrupted with widening of the distal tibiofibular articulation
    • medial malleolus fracture or deltoid ligament injury often present
    • fracture may arise as proximally as the level of fibular neck and not visualised on ankle films, requiring knee or full length tibia-fibula raiographs (Maissonneuve fracture)
    • unstable: usually requires ORIF
    • Weber C fractures can be further subclassified as 6
      • C1: diaphyseal fracture of the fibula: simple
      • C2: diaphyseal fracture of the fibula: complex
      • C3: proximal fracture of the fibula
        • fracture above the syndesmotic result from external rotation or abduction forces that also disrupt         the syndesmosis
        • usually associated with an injury to medial side

History and etymology

This classification was first described by Danis in 1949 and later modified and popularised by Weber in 1972 2:

  • Bernhard Georg Weber (1929-2002), an orthopaedic surgeon: St Gall, Switzerland
  • Robert Danis (1880-1962), general, thoracic, and vascular surgeon, Brussels.  Pioneer of internal fixation techniques 1,4

See also

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Article Information:

rID: 2283
System: Musculoskeletal
Section: Classifications
Tag: ankle
Synonyms or Alternate Spellings:
  • Danis-Weber classification
  • Weber classification
  • Danis-Weber ankle fracture classification
  • Ankle fracture (classification)-Weber
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    Figure 1: Weber classification
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    Case 1: Weber A
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    Figure 2
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    Case 2: Weber A
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    Case 3: Weber A
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    Case 4: Weber A
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    Case 6: Weber A
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    Case 5: Weber A
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    Case 7: Weber B
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    Case 8: Weber B
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    Case 9: Weber B
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    Case 10: Weber B
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    Case 11: Weber C
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    Case 12: Weber C
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    Case 13: Weber C
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    Case 14: Weber C
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    Case 15: Weber C
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    Case 16: Weber C
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