Weber A fibula fracture

Case contribution: Dr Radhiana Hassan

Clinical:

  • A 56 years old lady
  • No known medical illness
  • Had a fall, wearing high heels
  • Complaint of ankle pain and swelling after the fall
Ankle radiograph in AP and lateral views

Radiograph findings:

  • A transverse fracture is seen of distal fibula (yellow arrow)
  • The fracture line is seen below the syndesmosis
  • Minimal inferior displacement of fracture fragment
  • Soft tissue swelling seen surrounding the fracture region.
  • Presence of ankle effusion evidenced by anterior convex soft tissue density at tibiotalar joint on lateral view (white arrow).
  • Fat plane at pre-Achilles tendon also appear streaky (red arrow) suggestive of soft tissue inflammation.
  • Articulation of fibula with tibial fibular notch (blue arrows) is preserved.
  • Ankle mortise is normal (regular space over the entire talus measuring about 3-4 mm)
  • No other fracture of visualized bone is seen

Diagnosis: Weber A fibula fracture

Discussion:

  • Distal fibula fractures are the most common ankle injury
  • Classification of distal fibula fractures commonly used is Weber classification that use position of fracture relative to the syndesmosis
    • Weber A: below the syndesmosis and stable
    • Weber B: at the syndesmosis and may be unstable
    • Weber C: above the syndesmosis and unstable
Author: radhianahassan