Danis-Weber classification

The Danis-Weber classification (often known just as the Weber classification) is a method of describing Ankle fractures. It has 3 categories:^[1]

A

Fracture of the lateral malleolus distal to the syndesmosis (the connection between the distal ends of the tibia and fibula).

   * below level of the ankle joint
   * tibiofibular syndesmosis intact
   * deltoid ligament intact
   * medial malleolus often fractured
   * usually stable : occasionally nonetheless requires an open reduction and internal fixation (ORIF)

B

Fracture of the fibula at the level of the syndesmosis

   * at the level of the ankle joint, extending superiorly and laterally up the fibula
   * tibiofibular syndesmosis intact or only partially torn, but no widening of the distal tibiofibular articulation
   * medial malleolus may be fractured or deltoid ligament my be torn
   * variable stability

C

Fracture of the fibula proximal to the syndesmosis.

   * 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
   * unstable : requires ORIF

Categories B and C imply a degree of damage to the syndesmosis itself (which cannot be directly visualised on X-ray). They are inherently unstable and are more likely to require operative repair to achieve a good outcome. Type A fractures are usually stable and can be managed with simple measures, such as a plaster of paris cast.

References

1. ^ Mcrae, Ronald; Esser, Max Practical Fracture Treatment (Fifth ed.) p. 382 ISBN 978-0-443-06876-8