# Weber — Weber (Danis-Weber) classification of fibular ankle fractures

> Per-ankle label determined only by the fibular fracture level relative to the distal tibiofibular syndesmosis: A below, B at and C above. The type does not by itself prove syndesmotic or deltoid integrity, mortise stability, prognosis or need for surgery; report those findings independently.

**Situação:** vigente · **Órgão:** Musculoesquelético · **Órgão emissor:** Weber / ankle-trauma literature · **Versão:** Weber 1972 level classification; stability and care context reviewed through 2018 · **Ano:** 1972

> ⚠️ Uma versão mais nova pode existir (em revisão).

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: XR, CT
- Fonte primária: Weber BG. Die Verletzungen des oberen Sprunggelenkes (1972) — https://cir.nii.ac.jp/crid/1130000795807421952
- Última verificação: 2026-07-24
- Última checagem: 2026-08-12

## Lógica de decisão
Classify fibular fracture level only. Report mortise, medial column, posterior malleolus, syndesmosis, proximal fibula and urgency separately; no Weber type is inherently a treatment order.

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| A | Weber A, infrasyndesmotic fibular fracture | Weber A: the fibular fracture is below the distal tibiofibular syndesmosis (infrasyndesmotic). Assign the letter from level only; do not encode mortise stability or declare the syndesmosis and deltoid ligament intact without their own evidence. | Assess deformity, open injury, neurovascular status, mortise congruence, medial and posterior malleoli and syndesmotic or proximal-fibular injury independently. A fracture proven stable may follow a functional or nonoperative pathway, but type A alone does not forbid surgery or prove that pathway appropriate. | The distal level is an anatomic descriptor, not a guarantee of stability or a calibrated probability of displacement, nonunion, arthritis or good outcome. Coexisting medial, posterior, osteochondral or ligamentous injury can dominate risk. | Weber 1972 monograph bibliographic record for classification lineage; Lampridis et al., PMC5994620, Danis-Weber level definitions and stability limitations; BOAST 12 standards for assessment, reduction, imaging and stability-based care. | ✓ |
| B | Weber B, transsyndesmotic fibular fracture | Weber B: the fibular fracture crosses or is centered at the level of the distal tibiofibular syndesmosis (transsyndesmotic), often oblique or spiral. The letter alone does not determine deltoid, syndesmotic or mortise integrity. | Establish stability from mortise and medial-column findings, supported weight-bearing radiographs when clinically appropriate, and stress or operative assessment when indicated. Many isolated Weber B fractures are stable and nonoperative; unstable patterns may require fixation, but the letter neither mandates nor excludes surgery. | Type B spans stable and unstable injuries and has no patient-specific complication probability. The same fibular level can coexist with different medial and syndesmotic injuries, so raw findings and stability evidence are more informative than the letter alone. | Lampridis et al., EFORT Open Rev 2018, DOI 10.1302/2058-5241.3.170057, stability diagnosis, weight-bearing radiographs and treatment discussion; Hermans et al., PMC3368108, limited sensitivity of level classification for syndesmotic injury; BOAST 12, uncertain-stability review standard. | ✓ |
| C | Weber C, suprasyndesmotic fibular fracture | Weber C: the fibular fracture is above the distal tibiofibular syndesmosis (suprasyndesmotic). Examine and image the entire fibula when a proximal or Maisonneuve pattern is possible, but do not infer definite syndesmotic widening, deltoid rupture or mortise instability solely from the level. | Urgently reduce a deformed or neurovascularly threatened ankle and assess the mortise, medial column, posterior malleolus and syndesmosis directly. An unstable mortise or syndesmosis may require operative stabilization, yet type C itself does not mandate ORIF, select an implant or define operative levels. | A proximal fibular level is associated with concern for a more extensive injury pattern, but it is an imperfect proxy for actual ligament disruption and carries no calibrated individual probability of instability, arthritis, reoperation or functional loss. | Lampridis et al., PMC5994620, suprasyndesmotic definition and stability limitations; Hermans et al., DOI 10.1007/s00256-011-1284-2, MRI correlation showing level classification does not sensitively exclude syndesmotic injury; BOAST 12, whole-leg imaging, urgent reduction and syndesmotic assessment standards. | ✓ |

### Citações por categoria
- **A**: Lampridis V, Gougoulias N, Sakellariou A. Stability in ankle fractures: Diagnosis and treatment (2018) — https://pmc.ncbi.nlm.nih.gov/articles/PMC5994620/ · Weber 1972 monograph bibliographic record for classification lineage; Lampridis et al., PMC5994620, Danis-Weber level definitions and stability limitations; BOAST 12 standards for assessment, reduction, imaging and stability-based care.
- **B**: Lampridis V, Gougoulias N, Sakellariou A. Stability in ankle fractures: Diagnosis and treatment (2018) — https://pmc.ncbi.nlm.nih.gov/articles/PMC5994620/ · Lampridis et al., EFORT Open Rev 2018, DOI 10.1302/2058-5241.3.170057, stability diagnosis, weight-bearing radiographs and treatment discussion; Hermans et al., PMC3368108, limited sensitivity of level classification for syndesmotic injury; BOAST 12, uncertain-stability review standard.
- **C**: Lampridis V, Gougoulias N, Sakellariou A. Stability in ankle fractures: Diagnosis and treatment (2018) — https://pmc.ncbi.nlm.nih.gov/articles/PMC5994620/ · Lampridis et al., PMC5994620, suprasyndesmotic definition and stability limitations; Hermans et al., DOI 10.1007/s00256-011-1284-2, MRI correlation showing level classification does not sensitively exclude syndesmotic injury; BOAST 12, whole-leg imaging, urgent reduction and syndesmotic assessment standards.

## Referências cruzadas
- _fronteira compartilhada_ → [Lauge-Hansen — Lauge-Hansen classification of ankle fractures](https://radcommons.laudos.ai/systems/lauge-hansen.md) — Weber assigns A, B or C only from fibular fracture level relative to the syndesmosis. Lauge-Hansen describes inferred mechanism and staged component injuries; no automatic letter-to-mechanism crosswalk is valid.

## Histórico de versões

| Data | Evento | Detalhe | Situação |
| --- | --- | --- | --- |
| 2026-08-04 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-31 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-30 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-25 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2018-06-01 | revised | The EFORT stability review emphasized medial-column and mortise stability, weight-bearing assessment and the limitations of treatment decisions based on Weber type alone; this is a use boundary, not a new Weber version. | confirmed |
| 2016-08-01 | revised | BOAST 12 supplied current acute ankle-fracture assessment, imaging and stability-based care standards. It did not revise the A/B/C fibular-level definitions. | confirmed |
| 1972-01-01 | published | Weber published the three-level fibular ankle-fracture framework in Die Verletzungen des oberen Sprunggelenkes. | confirmed |


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> Conteúdo de referência reescrito. Confira a publicação primária vigente. Não é dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

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