Lauge-Hansen’s classification, which was published in a issue of Archives of Surgery, has become one of the most widely used ankle. The Lauge-Hansen classification is a system of categorizing ankle fractures based on the foot position and the force applied. Classification, Description, Notes. Supination External Rotation, Most common mechanism (% of all fractures). 1, Anterior tibiofibular ligament rupture.

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Verlag Hans Huber; Describe the number of malleoli involved and whether there are signs of instability classificationn dislocation. A novel methodology for the study of injury mechanism: In many cases it is visible on the radiographs of the ankle, but in some cases the fracture is located high and will only be visible on a radiograph of the lower leg.

Usually there is a total rupture laute the syndesmosis with instability of the ankle. The first ankle fracture classification, credited to Percival Pott, described three types of ankle fractures based on the number of malleoli involved: As stated before, the Danis-Weber system is based on fracture pattern that is determined from radiographic appearance and is not based on deduced and inaccurate concepts like foot position and mechanism of injury.

Lauge-Hansen classification – Wikipedia

This is a fracture above the level of the syndesmosis. National Center for Biotechnology InformationU.

Fibular plating with open correction of plafond impaction with medial classifucation antiglide plate. At reexamination you notice the subtle avulsion of the medial malleolus red arrowwhich is stage 1. Which of the following is most appropriate step based on Figures A and B? Example 1 Basic interpretation There is a medial malleolar fracture.

The soft tissue swelling on the medial side is probably a rupture of the medial collateral bandi.

There is an oblique fracture of the fibula. Despite its limitations, the Lauge-Hansen classification system continues to be one of the most widely used and accepted ankle fracture classification systems, and has enhanced our understanding of ankle fractures. According to Lauge Hansen the oblique fibular fracture indicates that this is a Supination Classificaiton injury stage 2 or higher. Inter-observer reliability and intra-observer reproducibility of the Weber classification of ankle fractures.


Finally, in Stage 4, the medial malleolus was fractured or the deltoid ligament was injured [ 12 ]. According to Lauge-Hansen this is stage 3 pronation exorotation injury and so the anterior syndesmosis stage 2 must also be ruptured. This is an unstable fracture that needs surgical repair. Stage-2 is extremely uncommon. Open reduction and internal fixation of the medial malleolus with syndesmosis reduction and suture-button repair.

Supination – External rotation. These are all stage-1 fractures. The radiographs show a clzssification Weber B fracture. Notice the oblique or vertical orientation of the push-off fibular fracture.

Classification The fracture starts at the level of the ankle joint and extends proximally, i.

Lauge Hansen calls this PE stage 1. Finally the posterior syndesmotic ligament ruptures, or there is an avulsion of the posterior malleolus, also known as posterior malleolus fracture red arrow. Re-examination On the hanaen films there was no sign of an oblique fracture of the lateral malleolus, so we can exclude a Weber B fracture.

In many cases the injury progresses to a higher stage. Weber C This is a fracture above the level of the syndesmosis. Author information Article notes Copyright and License information Disclaimer. Stage 1 The images show the usual Weber type A fractures. Weber B This is a transsyndesmotic fracture with usually partial – and less commonly, total – rupture of the syndesmosis.

Die Verletzungen des oberen Sprunggelenkes. On the lateral view the posterior cortex lauye the tibia is interrupted indicating a fracture blue arrow. A “simple” fracture of the lateral malleolus in a 50M C Trauma – Ankle Fractures HPI – Heavy weight injury 18 days ago, immediate pain, swelling ; diagnosed with left ankle fracture.


There is an avulsion fracture of the medial malleolus and a fibula fracture above the level of the syndesmosis. Ankle fractures are common musculoskeletal injuries that occur in a bimodal distribution, with peaks in younger men and older women [ 2 ], the former related to high-energy trauma and the latter to osteopenia and osteoporosis.

Fractures of the ankle: This classification system took into consideration the position lauve the distal fibular fracture in relation to the syndesmosis [ 427 ]. The radiographs shows a Weber C fracture. This is in contrast to the Danis-Weber classification that completely ignores the medial and posterior structures. First notice the oblique fibular fracture, which is best seen on the lateral view.

Almost always the avulsion is seen as a horizontal fracture.

Additional radiographs of the lower extremity were ordered and they demonstrate a high fibular fracture, i. SER stage 4 Lauge-Hansen.

Ankle Fractures

Re-examination Look for stage 3 and stage 4. In fact this is an unstable ankle fracture, since there also must be a rupture of the medial collateral ligament stage 1so the ring is broken in two places leading to instability. He subsequently undergoes surgical fixation, and classificatuon post-operative radiograph is shown in Figure A.

Classification The fracture is classified according to Weber as a type B fracture. Medial malleolus Anterior syndesmosis Fibula Posterior syndesmosis. Please review our privacy policy. This impression will direct you to both a Weber as well as a Lauge-Hansen classification. Ligamentous rupture or Avulsion Another important thing to remember is, that a ligament can rupture or cause an avulsion fracture at the insertion.