Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Ankle fractures — among the most common lower extremity fractures in adults — range from isolated lateral malleolus fractures that heal reliably with boot immobilization to complex bi- and trimalleolar fracture-dislocations requiring urgent surgical fixation to restore ankle stability. The Weber classification of lateral malleolus fractures and the concept of ankle stability are the two most important frameworks guiding management decisions.
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Weber Classification
The Danis-Weber classification categorizes lateral malleolus fractures by their relationship to the ankle syndesmosis — the fibular position determines the likelihood of syndesmotic injury and ankle instability. Weber A: fibula fracture below the syndesmosis (avulsion fracture from traction of the calcaneofibular ligament during inversion) — the syndesmosis is intact; the ankle is stable; conservative management in an orthopedic boot for 4–6 weeks with weight-bearing as tolerated. Weber B: fibula fracture at the level of the syndesmosis — the syndesmosis may or may not be disrupted; ankle stability requires clinical and radiographic assessment; isolated Weber B without medial-sided injury and with a stable mortise on stress testing is treated conservatively; Weber B with medial-sided injury (deltoid rupture or medial malleolus fracture) indicates mortise disruption requiring ORIF. Weber C: fibula fracture above the syndesmosis — the syndesmosis is disrupted; the ankle is unstable in virtually all cases; surgical fixation of the fibula and syndesmotic stabilization is required.
Stability Assessment and Operative Indications
The mortise view X-ray is the critical image: medial clear space >4mm, tibiofibular overlap <6mm, or lateral talar shift indicates ankle instability requiring surgical stabilization. Operative indications: unstable ankle fractures (any Weber C, Weber B with medial injury), displaced bimalleolar fractures, trimalleolar fractures (posterior malleolus fragment >25% of tibial plafond on lateral X-ray), and open fractures. Emergent reduction and splinting is required for ankle fracture-dislocations to prevent skin necrosis before definitive surgery. Dr. Biernacki at Balance Foot & Ankle evaluates ankle fractures with on-site X-ray, provides immediate immobilization and stability assessment, and coordinates surgical care for unstable injuries. Call (810) 206-1402 for urgent ankle fracture evaluation at our Bloomfield Hills or Howell office.
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Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
When to See a Podiatrist
Many foot conditions can be managed conservatively at home, but some require professional evaluation. See a podiatrist promptly if you experience:
- Pain that persists for more than 2 weeks despite rest
- Swelling, redness, or warmth that isn’t improving
- Numbness, tingling, or burning in the feet
- A wound or sore that is not healing within 2 weeks
- Any foot concern if you have diabetes or poor circulation
- Nail changes that suggest fungal infection or other problems
At Balance Foot & Ankle, our three board-certified podiatrists — Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin — provide comprehensive foot and ankle care at our Howell and Bloomfield Township offices. Most insurance plans are accepted.
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Board-certified podiatrists Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients daily at our Howell and Bloomfield Township, MI offices.
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Ankle Fracture Surgery (ORIF) in Michigan
When ankle fractures are unstable or displaced, surgical fixation (ORIF) restores joint alignment for the best long-term outcome. Our podiatric surgeons use Weber classification to guide surgical decision-making and perform expert plate and screw fixation.
Learn About Ankle Fracture Treatment | Book Your Appointment | Call (810) 206-1402
Clinical References
- Michelson JD. Fractures about the ankle. J Bone Joint Surg Am. 2005;77(1):142-152.
- SooHoo NF, Krenek L, Eagan MJ, et al. Complication rates following open reduction and internal fixation of ankle fractures. J Bone Joint Surg Am. 2009;91(5):1042-1049.
- Bauer M, Jonsson K, Nilsson B. Thirty-year follow-up of ankle fractures. Acta Orthop Scand. 1985;56(2):103-106.
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Howell Office
3980 E Grand River Ave, Suite 140
Howell, MI 48843
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Bloomfield Hills, MI 48302
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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
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