Danis-Weber Classification of Ankle Fractures

Original Editor - Kim Jackson Top Contributors - Kim Jackson

Introduction

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The Danis-Weber classification[1] (Weber classification) is a simple method for classifying fractures of lateral ankle fractures and is based on radiographic criteria. It takes into consideration the position of the distal fibular fracture in relation to the syndesmosis of the ankle joint. There are three classifications based on the location and type of fracture..

Classification

Type A - describes a fracture of the lateral malleolus distal to the syndesmosis (the connection between the distal ends of the tibia and fibula). Usually stable: but sometimes in need of an open reduction and internal fixation (ORIF) especially if the medial malleolus is fractured. Typical features :

  • Below the level of the tibial plafond (syndesmosis)
  • Tibiofibular syndesmosis intact
  • Deltoid ligament intact
  • Occasional oblique or vertical medial malleolus fracture

Type B - describes a fracture at the level of the tibial plafond (syndesmosis). Fracture of the fibula at the level of the syndesmosis. Variable stability. Typical features:

  • At the level of the ankle joint, extending proximally in an oblique fashion 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

Type C - describes a fracture proximal to the level of the tibial plafond and often have an associated syndesmotic injury. Unstable requiring ORIF.[2][3] Typical features:

  • Above the level of the ankle joint
  • Tibiofibular syndesmosis injured with widening of the distal tibiofibular articulation
  • Medial malleolus fracture or deltoid ligament injury may be present.

Conclusion

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

Resources

See also: Lauge-Hansen Classification of Ankle Fractures

References

  1. Kennedy JG, Johnson SM, Collins AL, DalloVedova P, McManus WF, Hynes DM, Walsh MG, Stephens MM. An evaluation of the Weber classification of ankle fractures. Injury. 1998 Oct 1;29(8):577-80.
  2. Goost H et al. Fractures of the Ankle Joint: Investigation and Treatment Options. Dtsch Arztebl Int. 2014; 111(21): 377-388.fckLRhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075279/
  3. Jason P. Tartaglione et al. Classifications in Brief: Lauge-Hansen Classification of Ankle Fractures. Clin Orthop Relat Res (2015) 473:3323–3328