Ankle Injury- Weber A

By MSK Teaching Cases

Last updated on: February 23, 2024

Inspecting the lateral malleolus first, the non displaced fracture line is below the syndesmosis (yellow band), so it's an infrasyndesmotic fracture - Weber A (supination adduction).  Next our eyes should be training on the expected oblique fracture at the base of the medial mal (blue line).  Looks intact to me. 

As a reasonable rule and as demonstrate on the Rad Asst Website, expect malleoli to:

fracture obliquely when colliding with the talus, 

fracture transversely when avulsed. 

Remember to look through the tibia to look for the fibula on your lateral. You'll see the fracture line again (red arrows) and other stuff.

And always inspect the posterior malleolus.  I know it's not part of the Weber A / SA pattern but stranger things will happen and it will strengthen your search pattern. 

Stage 1 Weber A - Supination Adduction injury.  Stable.

And for the MSK heads keeping score on ligaments, the Anterior Talofib (red scribble), Calcaneofib (blue scribble), and Posterior Talofib (yellow scribble) are responsible for the avulsion and pretty much holding on to a floating fibular fragment, so there is lateral ankle instability, it's just not ankle MORTISE instability. 

More information on Weber classifications within the article below!

https://radiologyassistant.nl/musculoskeletal/ankle/weber-and-lauge-hansen-classification

 

Author: MSK Teaching Cases