Danis-Weber classification

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

Classification

• type A
  • below the level of the syndesmosis (infrasyndesmotic)
  • usually transverse
  • tibiofibular syndesmosis intact
  • deltoid ligament intact
  • medial malleolus occasionally fractured
  • usually stable if medial malleolus intact
• type B
  • distal extent at the level of the syndesmosis (trans-syndesmotic); 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 the status of medial structures (malleolus/deltoid ligament) and syndesmosis;  may require ORIF
  • Weber B fractures could be further subclassified as
    • 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 syndesmosis (suprasyndesmotic)
  • tibiofibular syndesmosis disruption 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 visualized on ankle films, requiring knee or full-length tibia-fibula radiographs (Maisonneuve fracture)
  • unstable: usually requires ORIF
  • Weber C fractures can be further subclassified as
    • C1: diaphyseal fracture of the fibula, simple
    • C2: diaphyseal fracture of the fibula, complex
    • C3: proximal fracture of the fibula
      • a fracture above the syndesmosis results from external rotation or abduction forces that also disrupt the joint
      • usually associated with an injury to the medial side

History and etymology

This classification was first described by the Belgian general surgeon, Robert Danis (1880-1962), in 1949. It was later modified and popularized by the Swiss orthopedic surgeon, Bernhard Georg Weber (1929-2002), in 1972 .

See also

• Lauge-Hansen classification

Siehe auch:

• Weber-B-Fraktur
• Weber-C-Fraktur
• Weber-A-Fraktur
• Ligamentum collaterale mediale
• Pilon tibiale Fraktur
• distale Fibulafrakturen
• bimalleoläre Sprunggelenksfraktur
• Ottawa ankle rules
• kindliche Sprunggelenksfrakturen
• Lauge-Hansen classification
• trimalleoläre Sprunggelenksfraktur

und weiter:

• gebrochene Stellschraube
• Frakturen mit Eigennamen
• Fibulafraktur
• Fraktureinteilung
• fractures of the distal fibula
• radiologisches muskuloskelettales Curriculum
• Unterschenkelfraktur
• Kindliche Frakturen des OSG
• Weber B fracture and ORIF
• Frakturen der unteren Extremität