Abstract
Recent studies on fracture-dislocations of the ankle have brought a number of new findings that have questioned the so far generally accepted axioms of the Weber-AO classification:
1. Specification of a fracture-dislocation merely by the term "fracture of Weber type A, B or C" is inadequate. It is necessary to describe always also potential injuries to the medial structures and the posterior wall of the tibia.
2. The relation between the level of fracture on the tibia and injury to ligaments of the tibiofibular syndesmosis is not absolute in a number of cases.
3. In type C fractures, the interosseous membrane is not always ruptured up to the level of the fibula fracture.
4. In type C fractures, the posterior tibiofibular ligament may remain intact, without avulsion of the posterior wall.
5. In Weber B fractures, the anterior tibiofibular ligament is always injured (either intraligamentous tear or with separation of the bone insertion), and not only in 50% of cases.
6. In Weber B fractures, the posterior tibiofibular ligament may be injured (either intraligamentous injury or with separation of the bone), resulting in instability of the tibiofibular syndesmosis.
7. Essential for treatment is stability of the fracture that must be evaluated on static and dynamic radiographs.