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This consists of either interlocking intramedullary nails or an anatomical locking plate.

In cases where diastasis is evident, surgery may be required. For Danis-Weber Type A, once the bone is aligned and the ankle secured, a splint, cast or boot is recommended to maintain immobilization during healing, followed up with exercises to maintain muscle activity. The treatment plan depends on the severity of the fracture.

There is usually widening of the distal tibiofibular articulation and medial malleolus fracture or deltoid ligament injury may be present. A Danis-Weber Type C fracture is always unstable and occurs proximal to the level of the syndesmosis. The medial malleolus may be fractured or deltoid ligament may be torn. The tibiofibular syndesmosis is usually intact or only partially torn, but there is no widening of the distal tibiofibular articulation. A Danis-Weber Type B is a fracture at the level of the syndesmosis and has variable stability. The fracture is generally below the level of the tibial plafond, with an intact syndesmosis and deltoid ligament. 3 A Danis-Weber Type A is a fracture of the lateral malleolus distal to the syndesmosis and is usually stable unless there is also a medial malleolar fracture. The Danis-Weber classification grades the ankle fracture based on the location of distal fibular fracture as compared to the syndesmosis. Patients will almost always report moderate to severe pain and a possible inability to walk or apply pressure on the site of injury. 1,2Īnkle fractures can occur after a fall, twist, or direct hit to the bone. 1 Not surprisingly, there is a bimodal distribution with a peak during the years of 15-24, particularly in males, and then again between the ages 75 and above, when falls become more prominent, and osteoporosis sets in, particularly in women. Ankle fractures are common emergency department presentations, with an incidence of 187 per 100,000.