isolated medial malleolus fracture; isolated lateral malleolus fracture full-length tibia, or proximal tibia, to rule out Maisonneuve-type fracture. of the lower extremity were ordered and they demonstrate a high fibular fracture, i.e. Weber C stage 3 also known as a Maisonneuve fracture. Triplane fracture; Maisonneuve fracture; Tillaux fracture. juvenile Tillaux. Publicationdate October 1, The ankle is the most frequently injured joint.

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What is the most reliable method to evaluate the competence of the deltoid ligament? A tertius fracture is either Weber B stage 3 or – due to Weber C stage 4 arrows. The radiographs show a typical Weber B fracture. Thank you for updating your details. Here another typical Weber B fracture stage 4.

There are three situations in which we should suspect a high Weber C or Maisonneuve fracture: Open reduction and internal fixation with restricted weight bearing for 6 weeks.

On the AP-view the linear lucency is the clue to a tertius fracture red arrow. Fibular plating with open correction of syndesmosis and oblique medial malleolar screws. This is a Weber B stage 4 injury. We do not see a tertius fracture, which would indicate stage 4, but there may be a rupture of the posterior syndesmosis. Which of the following is unique with this particular ankle fracture pattern and must be recognized by the operating surgeon to optimize outcomes?

Stage 1 – Rupture of the anterior syndesmosis Stage 2 – Oblique fracture of the fibula this is the true Weber B fracture Stage 3 – Rupture of the posterior syndesmosis or – fracture of the posterior malleolus Stage 4 – Avulsion of the medial malleolus or – rupture of the medial collateral bands Scroll through the images. When these ankle injury types are seen, further imaging of the entire fibula is recommended to assess for an accompanying proximal fibular shaft fracture.


A type II growth plate fracture starts across the growth plate, but the fracture then continues up through the metaphysis. The CT-images show a epiphysiolysis fracture Salter Harris type 3.

Fractura de peroné

It will lead to rupture of the medial collateral ligament or avulsion of the medial malleolus. Lucent line on Mortise view black arrow and lateral view. Scroll through the images. It occurs before the distal tibial epiphysis has completely fused. She progressed well until 2 months ago when she notes heel deformity and ankle swelling.

Stage 2 is uncommon and easy to detect. An AP and lateral radiograph are shown in figures A and B respectively. We may have the following combination: Type IV is a fracture through all three elements of the bone, the growth plate, metaphysis and epiphysis.

Especially the medial swelling should make you consider a pronation exorotation injury Weber C. Classification Not possible to classify according to Weber, but according to Lauge Hansen a medial avulsion fracture indicates that the foot probably was in pronation at the moment of fractuga. There are subtle findings which indicate a fracture of the posterior malleolus. Four maisoonneuve later, he undergoes open reduction internal fixation.

So this is the fracture of the metaphysis in the coronal plane.

Ankle fracture – Weber and Lauge-Hansen Classification

Biomechanics deltoid ligament deep portion primary restraint to anterolateral talar displacement fibula acts as buttress to prevent lateral displacement of talus. Here a more subtle case. What is going on here? In some cases a fracture of the posterior malleolus is barely or not visible on the radiographs and can only be seen on CT.


The fracture through the epiphysis can be easily missed blue arrow. A “simple” fracture of the lateral malleolus in a 50M C Trauma – Ankle Fractures HPI – Heavy weight injury 18 days ago, immediate pain, swelling ; diagnosed with left ankle fracture. An AP ankle radiograph is provided in Figure A. Weber A fractures are usually not a maiosnneuve.

This is always above the level of the syndesmosis. Unable to process the form.

Wheeless’ Textbook of Orthopaedics

According to Lauge-Hansen this is stage 3 pronation exorotation injury and so the anterior syndesmosis stage 2 must also be ruptured. In daily practice most fracturra the Weber system, which is easy to memorize, while the Lauge-Hansen seems rather difficult at first glance.

We will first give a short overview of these fractures and then discuss them in more detail. These are all stage-1 fractures.

Do you see what stage this is? Which of the following is the best method to assess the integrity of the syndesmosis? We will now discuss the Weber classification and add the stages of the Lauge-Hansen system.