Danis–Weber classification

The Danis–Weber classification (often known just as the Weber classification) is a method of describing ankle fractures. It has three types: A, B, and C, based upon the location of fracture of the distal fibula.

Types

Fracture of the fibula distal to the tibiofibular syndesmosis (the connection between the distal ends of the tibia and fibula). Typical features:

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

Fracture of the fibula at the level of the syndesmosis. Typical features:

• 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 may be torn
• variable stability

Fracture of the fibula proximal to the syndesmosis. Typical features:

• 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.

See also

• Lauge-Hansen classification

References