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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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Description of the Lauge-Hansen System 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 clxssification the deforming forces abduction, adduction, or external rotation [ 12 hanen.

According to Lauge-Hansen this is stage 3 pronation exorotation injury and so the anterior syndesmosis stage 2 must also be ruptured. Inter-observer reliability and intra-observer reproducibility of the Weber classification of ankle fractures. First impression The radiographs show a fracture of the posterior malleolus. For each combination of foot position and deforming force, a consistently classiffication fracture pattern was elucidated.

Classification Not possible to classify according to Weber, but according to Lauge Hansen a medial avulsion fracture indicates that the foot probably was in pronation at the moment of injury. Final report Trimalleolar fracture. Classification Weber A and Supination Adduction stage 1. Haraguchi N, Armiger RS.

This is stage 2 and we have to assume, that the anterior syndesmosis is ruptured. Avulsion fracture of the medial malleolar. The sequences in a Weber B fracture or Lauge-Hansen supination exorotation injury take place in a clockwise manner:.


This is un unstable ankle injury that needs surgical repair. Notice that the fibular fracture is transverse, because it is an avulsion or pull-off fracture. What is an advantage of using lateral neutralization plating instead of posterior antiglide plating?

Lauge Hansen Classification of Ankle Fractures

Ligamentous rupture or Avulsion Another important thing to remember is, that a ligament can rupture or cause an avulsion fracture at the insertion. Looking at the classification system When we look at the scheme we will notice that a fracture of the posterior malleolus in most cases is part of a Weber B or a Weber C fracture. This impression will direct you to both a Weber as well as a Lauge-Hansen classification. Open reduction and internal fixation with restricted weight bearing for 2 weeks.

Weber B starts anterolaterally and the sequence is: Recommended management should consist of?

Lauge-Hansen classification of ankle injury

Stage-2 is extremely uncommon. More adduction force clzssification in the medial malleolus being pushed off in a vertical or oblique way.

Medial malleolus Anterior syndesmosis Fibula Posterior syndesmosis.

This is a fracture above the level of the syndesmosis. These are pull off type fractures as a result of avulsion. Pronation abduction injuries were evaluated in three experiments. The lateral malleolus cannot move away without breaking. This page was last edited on 27 Octoberat Immediately after the injury the injured parts may again align, which can make it difficult to detect the injuries. Medial and Lateral Bimalleolar Clxssification.

Classifications in Brief: Lauge-Hansen Classification of Ankle Fractures

Conclusions and Uses The Lauge-Hansen classification system was developed based on a cadaveric study which included imprecise replication of the true pathobiomechanics experienced during ankle fracture and incorporated deduced concepts like foot position at the time of injury and direction habsen the deforming force. Which of the following is unique with this particular ankle fracture pattern and must be recognized by the operating surgeon to optimize outcomes?


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.

According to Lauge Hansen the first injury is on the lateral side, which is under maximum tension. Cadaveric tibias were fixed with a vice and nails while a rotational deforming force was applied by hand with the foot in a supinated or pronated position.

In an attempt to account for these limitations, Kwon et al. Transverse fractures are thought to hanssn a product of pronation patterns of injury and vertical fractures are thought to represent supination injury patterns.

Verlag Hans Huber; This is an example of spanning external fixation used for ankle, pilon and other Therefore, it is not yet well understood how much clinical guidance the Lauge-Hansen system offers. Published online Apr The first ankle fracture classification, credited to Percival Pott, described three types of ankle fractures based on the number of malleoli involved: