Danis-Weber Classification of Ankle Fractures

The Danis-Weber classification, also known simply as the Weber classification¹, is a widely used radiographic system for categorizing lateral ankle fractures. It is based on the location of the fibular fracture in relation to the syndesmosis of the ankle joint.

The classification is divided into three main categories, describing the level and type of fracture:

Weber A

• Location: The fracture is below the level of the syndesmosis.

• Characteristics:

  • Typically a stable fracture

  • Syndesmosis usually intact

  • Minimal ligament damage

Weber B

• Location: The fracture occurs at the level of the syndesmosis.

• Characteristics:

  • May be stable or unstable depending on severity

  • Possible syndesmotic injury

Weber C

• Location: The fracture occurs above the level of the syndesmosis.

• Characteristics:

  • Often unstable

  • Syndesmosis injured or torn

  • Frequently associated with medial malleolus fracture or deltoid ligament injury

Clinical Relevance

• Type A fractures are usually stable and often managed conservatively with cast immobilization or orthoses. Prognosis is generally favorable.

• Type B and Type C fractures involve syndesmotic injury that may not be visible on plain X-ray. These are typically unstable fractures that more often require surgical fixation.

• Careful assessment of syndesmotic and ligamentous injury is essential, as these factors strongly influence ankle stability and treatment choice.

Conclusion

The Danis-Weber classification provides a simple, radiology-based method for categorizing ankle fractures.

• Type A: Usually stable, treated conservatively

• Type B: Variable stability, may need surgery

• Type C: Often unstable, typically requires surgical intervention

Correct classification and evaluation of syndesmotic involvement are critical for restoring ankle stability and function.

Sources:

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