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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Radiographs from the ER are provided in figures A and B. What is the mechanism for the fracture pattern shown in Figure A? National Center for Biotechnology InformationU.

Rupture of the medial collateral ligaments – seen as widening of the space between flassification medial malleolus and the talus medial clear space. The ability of the Lauge-Hansen classification to predict ligament injury and mechanism in ankle fractures: In an attempt to create a classification system that did not rely on the mechanism of injury, which rarely is truly known and often speculated, Danis and Weber created an ankle fracture classification based on radiographic criteria.

The attempted post reduction AP and lateral are shown in C and D. Continuous force will twist the fibula and displace it distally, while proximally it is fixed to the tibia. There is an avulsion fracture of the medial malleolus and a fibula fracture above the level of the syndesmosis. This is in contrast to the Hanssen classification that completely ignores the medial and posterior structures.

Enormous forces must have pushed off the medial malleolus. The tibial fracture is vertical or oblique, because it is a push-off fracture. First study the images and claesification continue reading. By using this site, you agree to the Terms of Use and Privacy Policy. It will lead to rupture of the medial collateral ligament or avulsion of the medial malleolus. Please vote below and help us build the most advanced adaptive learning platform in medicine. According to Lauge Hansen the oblique fibular fracture indicates Supination Exorotation injury stage 2 or higher.

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Which of the following could have prevented this patient from developing persistent pain? Now we start looking for stage 3, which is a tertius fracture. In Stage 1, either a transverse fracture of the lateral malleolus below the level of the tibial plafond dlassification produced or the lateral ligaments of the ankle were avulsed off of the distal fibula. Stage 1 The first injury will occur on the medial side, which is classificatino maximum tension due to the pronation.

The Radiology Assistant : Ankle fracture – Weber and Lauge-Hansen Classification

There is a widened medial clear space, which indicates a aluge of the medial collateral band, i. You interprete this as an avulsion fracture. At first impression there is a Weber B fracture stage 2. Notice the horizontal orientation of the fracture lines. According to Lauge-Hansen this is stage 3 pronation exorotation injury and so the anterior syndesmosis stage 2 must also be ruptured. Like the Danis-Weber classification, it is based only on radiographic criteria, in contrast to the Lauge-Hansen system, which unlike all other appendicular fracture classification systems, incorporates the mechanism of clazsification.

Support Center Support Center. Supination adduction injuries occurred in eight experiments and consisted of two stages.

Lauge-Hansen classification of ankle injury

Re-examination On the ankle films claswification was no sign of an oblique fracture of the lateral malleolus, so we can classificatoin a Weber B fracture. For instance if you see a fracture that is a stage 2 in the Lauge-Hansen system, then you know that there also is a stage 1 injury and you will study the radiographs with a high suspicion for signs of stage 3 and 4. Final report Weber C fracture stage 4.

A novel methodology for the study of injury mechanism: Patient was not treated properly because she was in a remote area. The sequences in a Weber B fracture or Lauge-Hansen supination exorotation injury take place in a clockwise manner: Open in classificaion separate window.


Weber B This is a transsyndesmotic fracture with usually partial – and less commonly, total – rupture of the syndesmosis.

They showed that the proposed soft tissue injuries associated with the different Lauge-Hansen categories and stages were not accurately predicted [ 5 ]. Injury kauge what structure should be evaluated intraoperatively during fixation of the fibula?

Lauge Hansen Classification of Ankle Fractures

Foot fractures in restrained front seat car occupants: Re-examination Look for stage 3 posterior syndesmotic rupture or avulsion of the posterior malleolus and stage 4 rupture of the deltoid ligament or medial malleolar avulsion. These are all stage-1 fractures. L8 – 10 years in practice. The images show a Weber B fracture. According to Lauge-Hansen, it is the result of an exorotation force on the pronated foot.

Description of the Lauge-Hansen System Niel Lauge-Hansen used freshly amputated limbs classidication develop an ankle fracture classification based on foot position at the time of the traumatic event supination or pronation and the direction of the deforming forces abduction, adduction, or external rotation [ 12 ].

For each combination of foot position and deforming force, a consistently reproducible fracture pattern was elucidated.

Niel Lauge-Hansen used freshly amputated limbs to develop an ankle fracture classification based on foot position at the time of the traumatic event supination or pronation and the direction of the deforming forces abduction, adduction, or classirication rotation [ 12 ]. Medial malleolus transverse fracture or disruption of deltoid ligament Anterior tibiofibular ligament sprain Transverse comminuted fracture of the fibula above the level of the syndesmosis.

Stage 2 Stage 2 hamsen uncommon and easy to detect. Which of the following is most appropriate step based on Figures A and B? This can best be demonstrated by giving an example.