Ankle Fractures: Lauge-Hansen Classification

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Questions and Answers

Using the Lauge-Hansen classification, list the stages of a Pronation-Abduction (PA) ankle injury.

Stage I: Transverse AVULSION fracture of medial malleolus / deltoid ligament rupture, Stage II: AITFL syndesmotic rupture or avulsion of its insertion, Stage III: Short oblique fracture of lateral malleolus / fibula (Weber B).

Using the Lauge-Hansen classification, list the stages of a Pronation External Rotation (PER) ankle injury.

Stage I: Transverse AVULSION fracture of medial malleolus / rupture of deltoid ligament, Stage II: AITFL syndesmotic rupture or avulsion of its insertion (Tillaux-Chaput fracture), Stage III: Oblique or spiral fibular fracture above the joint (Weber C / Maisonneuve Fracture), Stage IV: PITFL syndesmotic rupture or avulsion of posterior lateral malleolus (Volkmann's fracture).

Using the Lauge-Hansen classification, list the stages of a Supination Adduction (SA) ankle injury.

Stage I: Rupture of Lateral collateral ligaments, avulsion fracture of the lateral malleolus, transverse fracture of distal fibula below level of ankle joint (Weber A), Stage II: Oblique/Near VERTICAL fracture of medial malleolus.

What is the most common mechanism of fracture when dealing with the Lauge-Hansen classification?

<p>Supination External Rotation (SER), Accounts for 40-70% of all ankle fractures.</p> Signup and view all the answers

Using the Lauge-Hansen classification, list the stages of a Supination External Rotation (SER) ankle injury.

<p>Stage I: AITFL syndesmotic rupture / fracture of distal lateral tibia (Tillaux-Chaput Fracture), Stage II: Spiral fracture of the fibula (Weber B), Stage III: PITFL syndesmotic rupture / avulsion (Volkmann's fracture), Stage IV: Transverse avulsion fracture of medial malleolus or rupture of deltoid ligament.</p> Signup and view all the answers

Flashcards

PA Ankle Injury Stages

I: Medial malleolus avulsion/deltoid rupture. II: AITFL syndesmotic rupture/avulsion. III: Short oblique fibula fracture (Weber B).

PER Ankle Injury Stages

I: Medial malleolus avulsion/deltoid rupture. II: AITFL syndesmotic rupture/avulsion (Tillaux-Chaput). III: Oblique/spiral fibula fracture above joint (Weber C/Maisonneuve). IV: PITFL syndesmotic rupture/posterior malleolus avulsion (Volkmann's).

SA Ankle Injury Stages

I: Lateral collateral ligament rupture/fibular avulsion/transverse fibula fracture (Weber A). II: Oblique/vertical fracture of medial malleolus.

Most Common Ankle Fracture Mechanism

Accounts for 40-70% of all ankle fractures, and it is the most common based on the Lauge-Hansen classification.

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SER Ankle Injury Stages

I: AITFL syndesmotic rupture/distal lateral tibia fracture (Tillaux-Chaput). II: Spiral fibula fracture (Weber B). III: PITFL syndesmotic rupture/avulsion (Volkmann's). IV: Transverse avulsion fracture of medial malleolus/deltoid rupture.

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Study Notes

Pronation-Abduction (PA) Ankle Injury

  • Stage I: Transverse avulsion fracture of the medial malleolus; associated with deltoid ligament rupture.
  • Stage II: Anterior inferior tibiofibular ligament (AITFL) syndesmotic rupture or avulsion.
  • Stage III: Short oblique fracture of the lateral malleolus (Weber B classification); visible as transverse on lateral radiograph.

Pronation External Rotation (PER) Ankle Injury

  • Stage I: Transverse avulsion fracture of the medial malleolus; involves rupture of the deltoid ligament.
  • Stage II: AITFL syndesmotic rupture or avulsion, referred to as Tillaux-Chaput fracture.
  • Stage III: Oblique or spiral fracture of fibula above the joint (Weber C/Maisonneuve fracture).
  • Stage IV: Posterior inferior tibiofibular ligament (PITFL) syndesmotic rupture or avulsion of the posterior lateral malleolus; known as Volkmann's fracture.

Supination Adduction (SA) Ankle Injury

  • Stage I: Rupture of lateral collateral ligaments; avulsion fracture of the lateral malleolus; transverse fracture of the distal fibula below the ankle joint (Weber A).
  • Stage II: Oblique or near vertical fracture of the medial malleolus.

Supination External Rotation (SER) Ankle Injury

  • Stage I: AITFL syndesmotic rupture/fracture of distal lateral tibia; known as Tillaux-Chaput fracture.
  • Stage II: Spiral fracture of the fibula (Weber B classification); Wagstaffe fracture may occur at this stage.
  • Stage III: PITFL syndesmotic rupture or avulsion; known as Volkmann's fracture with avulsion of postero-lateral tibia.
  • Stage IV: Transverse avulsion fracture of the medial malleolus or rupture of the deltoid ligament.

Mechanism of Fracture

  • Supination External Rotation (SER) is the most common mechanism for ankle fractures, accounting for 40-70% of all cases.

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