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

Siehe auch:
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