Weber classification of ankle fractures
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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
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type A
- below the level of the talar dome
- usually transverse
- tibiofibular syndesmosis intact
- deltoid ligament intact
- medial malleolus often fractured
- usually stable if medial malleolus intact: occasionally nonetheless requires an open reduction and internal fixation (ORIF)
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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
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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 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 films (Maissonneuve fracture)
- unstable: usually requires ORIF
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
-<li>fracture may arise as proximally as the level of fibular neck and not visualised on ankle films, requiring knee or full length tibia-fibula films (<a title="Maissonneuve fracture" href="/articles/maissonneuve-fracture">Maissonneuve fracture</a>)</li>- +<li>fracture may arise as proximally as the level of fibular neck and not visualised on ankle films, requiring knee or full length tibia-fibula films (<a href="/articles/maissonneuve-fracture">Maissonneuve fracture</a>)</li>
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