Morphological Study of Weber Type A Lateral Malleolar Fractures.

OBJECTIVE

Morphological studies of Weber Type A lateral malleolar fractures (LMFs) are scarce, and no classification criteria exist specifically for this fracture type. Therefore, our objective is to describe the distribution of Weber Type A LMF and propose a classification based on three-dimensional computed tomography (CT) and fracture mapping techniques.

METHODS

We retrospectively reviewed 586 patients presenting with lateral malleolar fractures at our hospital between June 2016 and May 2024. CT data were reconstructed and reduced using software, and fracture lines were delineated. Fracture lines from all patients were superimposed to generate fracture maps and heatmaps. Fracture section area (FSA) was also measured for each case. Using the Kolmogorov-Smirnov test to assess the normality of the data distribution and the Kruskal-Wallis test to compare the FSA values among different fracture subtypes.

RESULTS

A total of 81 Weber type A LMFs were included. Based on the fracture morphology and its relationship with the fibular obscure tubercle (FOT) and inferior tip of the fibula (ITF), Weber type A LMFs were classified into three types: Type I: Anteroinferior (25 cases, 30.9%); Type II: Posteroinferior (32 cases, 39.5%); Type III: Metaphyseal (24 cases, 29.6%).

CONCLUSIONS

This study revealed the morphological characteristics of Weber type A LMF, enhanced understanding of the underlying injury mechanisms, and provided guidance for making diagnostic and therapeutic decisions.