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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Adduction- tilts medial talus upwards. Weber B starts anterolaterally and the sequence is: Injury patterns isolated medial malleolus fracture isolated lateral malleolus fracture bimalleolar and bimalleolar-equivalent fractures posterior malleolus fractures Bosworth fracture-dislocations open ankle fractures associated syndesmotic injuries isolated syndesmosis injury.
Every ligamentous rupture has it’s avulsion hanssen counterpart. Open reduction internal fixation of the fibula with syndesmosis reduction and suture-button repair. 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.
In many cases the injury progresses to a higher stage. Appropriate reconstruction therefore is important, and a classification scheme that identifies nansen patterns and guides treatment would be desirable.
Due to the pronation, the lateral ligaments are not under tension and the fibula can move away from the tibia. His pedal pulses are palpable. However, it is essential that future studies continue to investigate mechanism of injury, fracture patterns, and optimal treatments for ankle fractures.
Pronation external rotation injuries were recreated in four experiments, with either deltoid ligament rupture or avulsion fractures of the medial malleolus evident in Stage 1. What structure is most likely preventing reduction? Final report Weber B fracture.
Finally, in Stage 4, the medial malleolus was fractured or the deltoid ligament was injured [ 12 ].
How important is lague topic for board examinations? This was the impetus for the work of Niel Lauge-Hansen —a Danish physician who studied ankle fractures during the s and s, ultimately creating a classification system based on a rotational mechanism of injury [ 11 — 15 ].
This is un unstable ankle injury that needs surgical repair. Fractures of the ankle: Re-examination On the ankle films there was no sign of an oblique fracture of the lateral malleolus, so we can exclude a Weber B fracture. Stage Stage 3 More posterior displacement of the lateral malleolus fragment by the talus results in tension on the posterior syndesmosis with rupture or avulsion of the posterior malleolus.
The Radiology Assistant : Ankle fracture – Weber and Lauge-Hansen Classification
At reexamination you notice the subtle avulsion of the medial malleolus red arrowwhich is stage 1. Which of the following statements accurately describe this radiograph? In Stage 3, transverse or comminuted fibula fractures were observed above the level of the tibial plafond [ 12 ]. Comparing radiographs with corresponding MR images of 51 ankle fractures, Hermans et al. Retrieved 27 October Her postoperative classivication are shown in Figure A.
This article about Orthopedic surgery is a stub. J Foot Ankle Surg. On the lateral view the posterior cortex of the tibia is interrupted indicating a fracture blue arrow. Additionally, ankle fractures that are poorly reduced result in worse overall patient outcomes than fractures with a well-aligned ankle mortise [ 9 ].
From Wikipedia, the free encyclopedia. Final report Weber C fracture stage 4. What is an advantage of using lateral neutralization plating instead of posterior antiglide plating? Injury to what structure should be evaluated intraoperatively during fixation of the fibula?
Open reduction and internal fixation of the medial malleolus with syndesmosis reduction and suture-button repair. We lauhe not see a tertius fracture, which would indicate stage 4, but there may be a rupture of the posterior syndesmosis. Stage 1 – Avulsion of the medial malleolus or – ligamentous rupture Stage 2 – Rupture of the anterior syndesmosis Stage 3 – Fibula fracture above the level of the syndesmosis this is the true Weber C fracture Stage 4 – Avulsion of the posterior malleolus or – rupture of the posterior syndesmosis Scroll through the images.
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. Please login to add comment.
Rupture of the anterior syndesmosis – seen as widening of the space between the distal tibia and fibula classificahion clear space.
Lauge Hansen Classification of Ankle Fractures
Sometimes CT is needed to get a better impression of the size of the fracture fragment of the posterior malleolus. Later investigators have been unable to duplicate the mechanical events or injuries described by Lauge-Hansen.
Danis-Weber Type C fractures occur proximal to the level lakge the tibial plafond and often have an associated syndesmotic injury [ 41227 ], which correlates with pronation external rotation Fig. This is a Weber B stage 4 injury. Now we start looking for stage 3, which is a tertius fracture.
Classifications in Brief: Lauge-Hansen Classification of Ankle Fractures
Enormous forces must have pushed off the medial malleolus. Exorotation injury Weber A fractures are usually not a problem.
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. This is a transsyndesmotic fracture with usually partial – and less commonly, total – rupture of the syndesmosis.
The fracture is consistent with a Lauge-Hansen pronation-external rotation injury pattern. Pronation – External rotation. Is this a case of a simple lateral malleolus fracture? Tertius fracture – seen on AP view red arrow and on lateral view yellow arrow.
HPI – Initial trauma was 3 months ago. L6 – years in practice. Correlation of AO and Lauge-Hansen classification systems for ankle fractures to the mechanism of injury.