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Ankle Fractures

Classifications

1. Lauge-Hansen

  • Cadaveric study which relates the fracture pattern to an injury mechanism
  • The first word in the designation refers to the foot's position at the time of injury; the second word refers to the direction of the deforming force. 

  • ''eversion'' is a misnomer; it more correctly should be ''external'' or ''lateral'' rotation

Type of injury (foot position/direction of force)

Pathology

Supination/adduction

Transverse # of fibula/tear of collateral ligaments - vertical # medial malleolus

Supination/eversion (external rotation)

1.Disruption of the anterior tibiofibular ligament 
2.Spiral oblique fracture of the distal fibula 
3.Disruption of the posterior tibiofibular ligament or fracture of the posterior malleolus 
4.Fracture of the medial malleolus or rupture of the deltoid ligament 

Pronation/abduction

1.Transverse fracture of the medial malleolus or rupture of the deltoid ligament 
2.Rupture of the syndesmotic ligaments or avulsion fracture of their insertion(s) 
3.Short, horizontal, oblique fracture of the fibula above the level of the joint

Pronation/eversion

1.Transverse fracture of the medial malleolus or disruption of the deltoid ligament 
2.Disruption of the anterior tibiofibular ligament 
3.Short oblique fracture of the fibula above the level of the joint 
4.Rupture of posterior tibiofibular ligament or avulsion fracture of the posterolateral tibia

Pronation/Dorsiflexion (Pilon) 1.Fracture of the medial malleolus 
2.Fracture of the anterior margin of the tibia 
3.Supramalleolar fracture of the fibula 
4.Transverse fracture of the posterior tibial surface


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