Danis–Weber classification

Types

;Type A Fracture of the fibula distal to the tibiofibular syndesmosis (the connection between the distal ends of the tibia and fibula). Typical features:

• below level of the ankle joint
• tibiofibular syndesmosis intact
• deltoid ligament intact
• medial malleolus occasionally fractured
• usually stable: occasionally nonetheless requires an open reduction and internal fixation (ORIF) particularly if medial malleolus fractured

;Type B Fracture of the fibula at the level of the syndesmosis. Typical features:

• at the level of the ankle joint, extending superiorly and laterally 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
• variable stability

;Type C Fracture of the fibula proximal to the syndesmosis. Typical features:

• above the level of the ankle joint
• tibiofibular syndesmosis disrupted with widening of the distal tibiofibular articulation
• medial malleolus fracture or deltoid ligament injury present
• unstable: requires ORIF

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

References

References

1. (2008). "Practical Fracture Treatment".