Webber A, B and C Fractures
Figure 1 - An inversion mechanism (see above) is involved in most ankle injuries, and can lead to associated ligamentous injury, as well as Weber type fractures, Set in Motion Physiotherapy, Frenchs Forest.
Weber A, B, and C fractures are classifications used to describe fractures involving the fibula, a bone on the outside of the lower leg. Like most ankle injuries, an inversion mechanism (where the ankle rolls underneath the body) is normally involved. Such fractures can coincide with associated ligament injury. The Weber classification system is often used to characterise the severity of the fracture, as well as the extent of associated ligamentous damage. The Weber classification is commonly used by orthopaedic surgeons and physiotherapists to guide treatment decisions.
Weber A Fracture:
In a Weber A fracture, the fibula is fractured below the level of the syndesmosis (the joint between the tibia and fibula).
The syndesmosis and the deltoid ligament, which stabilizes the medial side of the ankle, are usually not disrupted.
Weber A fractures are considered stable, meaning that they are unlikely to worsen with correct treatment and management.
Treatment involves a period of weight-bearing in a CAM Boot (Moon Boot) and physiotherapy upon removal of this boot.
Weber B Fracture:
In a Weber B fracture, the fibular fracture is at the level of the syndesmosis.
The syndesmosis may be disrupted, leading to instability in the ankle joint.
These fractures are intermediate in terms of stability, meaning that carefully examination and treatment is required to ensure acceptable healing.
Treatment involves surgical management OR a period of reduced weightbearing in a CAM Boot (Moon Boot). Physiotherapy is required after orthopaedic opinion, to regain ankle range of motion and strength.
Weber C Fracture:
In a Weber C fracture, the fibula is fractured above the syndesmosis.
The syndesmosis and the deltoid ligament are often not involved, but the fracture may extend into the ankle joint.
These fractures are considered unstable.
Treatment involves surgical management and an extended period of time in a CAM Boot (Moon Boot), with no weight-bearing allowed as per your surgeon’s preference. Physiotherapy is required when your surgeon allows it, and is very importance in regaining full range of motion, strength and function of your injured ankle.
Figure 2 - Weber Classification of Fibula Fractures, Set in Motion Physiotherapy, Frenchs Forest.
The classification helps guide treatment decisions, with Weber A fractures often treated non-operatively, Weber B fractures requiring careful evaluation and sometimes surgical intervention, and Weber C fractures typically requiring surgical management to restore stability to the ankle joint. Full timeframes for recovery from a Weber fracture can vary depending on the severity of the injury and therefore the chosen treatment option, with Weber A fractures frequently ready to return to activities 12 weeks post injury. Operative management of Weber B or C fractures can delay this timeframe.
It's important to note that while the Weber classification provides a useful framework, individual cases may vary, and treatment decisions should be made based on a comprehensive assessment of the patient's overall condition and the specific characteristics of the fracture. In the WISE Fracture Clinic, orthopaedic surgeons and physiotherapists work together to ensure Weber fractures are managed correctly. Depending on the severity of the injury, x-rays may provide enough information to inform treatment, or an MRI may be requested to further outline the extent of associated ligamentous injury.