Three ankle films, three fibula fractures — the classification?
OrthoVellum Editorial · today
The case
These three ankle radiographs (A, B, C) each show a fibular fracture at a different level. What classification system does this illustrate, and why does the level of the fibular fracture matter for ankle stability?
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This is the Weber (Danis–Weber) classification, based on the level of the fibular fracture relative to the syndesmosis: Weber A is below the syndesmosis (usually stable), Weber B is at the level of the syndesmosis (variable — depends on the medial side), and Weber C is above the syndesmosis (syndesmosis disrupted, unstable). The higher the fibular fracture, the more likely the syndesmosis is injured and the mortise unstable — so the level guides whether the injury needs fixation and syndesmotic stabilisation.
- Weber A below / B at / C above the syndesmosis
- Higher fibular fracture means greater syndesmotic disruption and less stability
- Assess the medial clear space and talar shift to judge stability
- Weber level guides operative decisions and the need for syndesmotic fixation
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