Danis-Weber classification

Description

The Danis-Weber classification is a method of describing ankle fractures. It is a simple system for the classification of lateral malleolar fractures, relating to the level of the fracture in relation to the ankle joint, specifically the distal tibiofibular syndesmosis.

The classification has three primary categories, based primarily upon the fracture of the fibula, and has a role in determining treatment

• Type A. Fracture of the fibula distal to syndesmosis. An oblique medial malleolus fracture may also be present.
• Type B. Fracture of the fibula at the level of the syndesmosis. These fractures may be stable or unstable, based upon the presence of deltoid ligament rupture or medial malleolus fracture.
• Type C. Fracture of the fibula proximal to syndesmosis. These unstable fractures are generally associated with syndesmosis injuries, and may include medial malleolus fracture or deltoid ligament rupture.

History of the Danis-Weber classification

1949 – Robert Danis published ‘Théorie et pratique de l’ostéosynthèse‘ providing early basis to classification

1972 – Bernhard Georg Weber developed and popularised classification system still used in practice today

This simple ankle fracture classification system is more commonly called the Weber ankle fracture classification. It has three categories, based primarily upon the fracture of the fibula.

Weber on the syndesmosis

The height of the fibular lesion is directly connected to the condition of the syndesmosis, regardless of whether there is a medial ankle injury, and of what type this may be. 

Weber BG, 1972

Associated Persons

• Robert Danis (1880-1962) [Danis-Weber classification]
• Bernhard Georg Weber (1927-2002) [Weber classification]
• Niels Lauge-Hansen (1899-1976) [Lauge-Hansen classification]

Alternative names

• Weber classification

Controversies

• Danis-Weber classification system was first described by Robert Danis in 1949 and later modified and popularised by Bernhard Georg Weber in 1972, 10 years after Danis’ death.
• This simple ankle fracture classification system is more commonly called the Weber ankle fracture classification
• The Lauge-Hansen classification of rotational ankle fractures, based upon the position of the foot at time of injury, was described in 1950, 22 years prior to Weber’s description

References

Original articles

• Danis R. Les fractures malleolaires. In: Theorie et pratique de l’osteosynthese. Masson et Cie, Paris, 1949: 133-165
• Weber BG. Aktuelle probleme in der chirurgie. Band 3. Die Verletzungen des oberen Sprunggelenkes [The injuries of the upper ankle] 2e, 1972

Historical review

• Lauge-Hansen N. Fractures of the ankle. II. Combined experimental-surgical and experimental-roentgenologic investigations. Arch Surg. 1950 May;60(5):957-85.
• Hughes JL, Weber H, Willenegger H, Kuner EH. Evaluation of ankle fractures: non-operative and operative treatment. Clin Orthop Relat Res. 1979 Jan-Feb;(138):111-9
• Somford MP, Wiegerinck JI, Hoornenborg D, van den Bekerom MPJ. Ankle fracture eponyms. JBJS 2013; 95(24): e198
• Cadogan M. Eponymous Foot, ankle and talus injuries. LITFL
• Cadogan M. Danis-Weber classification. Eponym A Day. Instagram

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