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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Stage 1 The first injury will occur on the medial side, which is under maximum tension due to the pronation. An intraoperative fluoroscopy image is provided in figure C. Immediately after the injury the injured parts may again align, which can classificatoin it difficult to detect the injuries. J Foot Ankle Surg. Final report Weber B fracture. This is a fracture above the level of the syndesmosis. Add posterior tibiofibular ligament rupture, or posterior malleolar fracture.
We do not see a tertius fracture, which would indicate stage 4, but there may be a rupture of the posterior syndesmosis. L6 – years in practice. Studies have shown that a small percentage of ankle fractures, such as isolated fractures of the posterior tibial margin, do not fit into the Lauge-Hansen classification [ 528 ]. Which of the following could have prevented this patient from developing persistent pain?
Lauge-Hansen classification of ankle injury | Radiology Reference Article |
However, it is essential that future studies continue to investigate mechanism of injury, fracture patterns, and optimal treatments for ankle fractures. 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.
A classification system should be comprehensive and have the capacity to describe all the types of fractures in its range of classification. Bone fractures Ankle fracture classifications Injuries of ankle and foot Orthopedics stubs. Weber B This is a transsyndesmotic fracture with usually partial – and less commonly, total – rupture of the syndesmosis. These images show another typical Weber B fracture stage 4. Stage 2 is unstable because the ring of the ankle is broken in two places.
There is an avulsion of the posterior malleolus and an avulsion of the medial malleolus. According to Lauge-Hansen the fracture results from an exorotation force on the pronated foot.
Partial weight bearing starting 1 week after the trauma. There are subtle findings which indicate a fracture of the posterior malleolus.
The soft tissue swelling on the medial side is probably a rupture of the medial collateral bandi. Notice that all 4 stages are visible: Contrary to the findings of Hermans et al.
Open reduction and internal fixation with restricted weight bearing for 12 weeks. Such methodology is not only imprecise but also fails to accurately recreate the in vivo forces experienced by a patient while sustaining an ankle fracture; namely the combination of axial load and rotational forces as the body moves relative to a foot planted on the ground. Stage 1 – Avulsion of the medial malleolus or – ligamentous rupture Stage 2 – Rupture of the anterior classificaton Stage 3 – Fibula fracture above the level of the syndesmosis this is the true Weber C fracture Stage ahnsen – Avulsion of the posterior malleolus or – rupture of the posterior syndesmosis Scroll through the images.
Re-examination Look for stage 3 and stage 4. Example 2 Basic interpretation Transverse lateral malleolar fracture. Open reduction and internal fixation with restricted weight bearing for 6 weeks. Here another typical Weber B fracture stage 4.
Ankle fracture – Weber and Lauge-Hansen Classification
HPI – Heavy weight injury 18 days ago, immediate pain, swelling ; diagnosed with left ankle fracture. However, this system ignores the medial side of the ankle, which plays an important role in determining ankle stability and function. Die Verletzungen des oberen Sprunggelenkes.
The tibial fracture is vertical or oblique, because it is a push-off fracture. A tertius fracture is either Weber B stage 3 or – due to Weber C stage 4 arrows. The lateral malleolus cannot move away without breaking.
Originally, the Lauge-Hansen luage system was created to direct closed reduction.
Foot fractures in restrained front seat car occupants: The Lauge-Hansen classiflcation will give you the fracture mechanism and the preliminary stage of the ankle injury. Clinical use of genetic roentgenologic diagnosis and genetic reduction. First study the images and then continue reading. Primary and late results of the operative and non-operative treatment.
Medial and Lateral Bimalleolar Fracture. This is an unstable fracture with dislocation that needs surgical repair.
He subsequently undergoes surgical fixation, and a post-operative radiograph is shown in Figure A. As a result more rotation of the talus will fracture the fibula in an oblique or spiral fashion because the lateral malleolus is pushed off from anteromedially to posterolaterally.
HPI – Initial trauma was 3 months ago. The images show the usual Weber type A fractures. The sequences in a Weber B fracture or Lauge-Hansen supination exorotation injury take place in a clockwise manner:. It is the most difficult fracture to diagnose and the Lauge-Hansen system will help you to understand the fracture-mechanism, as this will be an enormous help.