Danis-Weber and Lauge-Hansen Classifications

Questions and Answers

What is Danis-Weber Type A? Which Lauge-Hansen classification would it be in?

Fracture line below tib-fib syndesmosis. = SAD

What is Danis-Weber Type B? Which Lauge-Hansen classification would it be in?

Fracture line at the level of tib-fib syndesmosis = Straight oblique --> PAD; = Spiral oblique --> SER

What is Danis-Weber Type C? Which Lauge-Hansen classification would it be in?

Fracture line above tib-fib syndesmosis = Straight oblique --> Pronation dorsiflexion; = Spiral oblique --> PER

What are the 4 Lauge-Hansen classifications for an ankle fracture? Additionally, indicate if it's due to a direct blow injury or clockwork injury.

<ol> <li>SAD = direct blow; 2. SER = clockwork; 3. PAB = direct blow; 4. PER = clockwork</li> </ol> Signup and view all the answers

What are the 2 stages for SAD (supination adduction)? What Danis-Weber classification would this be?

SAD-I: Straight transverse fracture of the lateral malleolus below the ankle joint (or rupture of LCLs) = Danis-Weber A; SAD-II: Oblique fracture of the medial malleolus. Signup and view all the answers

What are the 4 stages for SER (supination external rotation)? What Danis-Weber classification would this be? Also name the specific avulsion fractures you would see at each.

SER-I: AITFL ruptures or Tillaux-Chaput (tibia)/Wagstaffe (fibula) avulsion fracture; SER-II: Spiral oblique fracture of the lateral malleolus at the level of the ankle joint = Danis-Weber B; SER-III: PITFL ruptures or Volkmann's avulsion fracture (posterior lip of tibia); SER-IV: Straight transverse fracture of medial malleolus (or deltoid ligament rupture). Signup and view all the answers

What are the 3 stages for PAB (pronation abduction)? What Danis-Weber classification would this be?

PAB-I: Straight transverse fracture of the medial malleolus (or deltoid ligament rupture); PAB-II: Both AITFL/PITFL ruptured (no diastasis); PAB-III: Straight oblique fracture of the lateral malleolus at the level of ankle joint = Danis-Weber B. Signup and view all the answers

What are the 4 stages for PER (pronation external rotation)? What Danis-Weber classification would this be? Also name the specific avulsion fractures you would see at each.

PER-I: Straight transverse fracture of medial malleolus (or deltoid ligament rupture); PER-II: AITFL rupture + tear of tib-fib interosseous membrane (diastasis) or Tillaux-Chaput/Wagstaffe fragment; PER-III: Spiral oblique fracture of fibula above ankle joint = Danis-Weber C; PER-IV: Volkmann's avulsion fracture (posterior tibial lip of tibia) or rupture of PITFL. Signup and view all the answers

What are Tillaux-Chaput and Wagstaffe avulsion fractures? Which stages of Lauge-Hansen do they occur?

Tillaux-Chaput = Anterolateral tubercle of tibia (medial AITFL insertion point); Wagstaffe = Anterior portion of fibula (lateral AITFL insertion point). Lauge-Hansen SER I, PAB II, PER II. Signup and view all the answers

What is a Volkmann avulsion fracture? Which stages of Lauge-Hansen does it occur in?

Volkmann's fracture: Posterior lip of tibia (attaches PITFL). Lauge-Hansen SER III, PER IV. Signup and view all the answers

Study Notes

Danis-Weber Classification

Type A: Fracture line located below the tibiofibular syndesmosis; associated with Supination Adduction (SAD) injury mechanism.
Type B: Fracture line at the level of the tibiofibular syndesmosis; corresponds to two potential mechanisms: Straight Oblique (PAD) or Spiral Oblique (SER).
Type C: Fracture line above the tibiofibular syndesmosis; linked with Pronation Dorsiflexion injuries, classified as either Straight Oblique (PER) or Spiral Oblique.

Lauge-Hansen Classifications

Four classifications for ankle fractures:
- SAD: results from a direct blow.
- SER: caused by a clockwork injury.
- PAB: occurrence due to a direct blow.
- PER: attributed to a clockwork injury.

Supination Adduction (SAD) Stages

SAD-I: Straight transverse fracture of the lateral malleolus below the ankle joint (or lateral collateral ligament rupture); classified as Danis-Weber A.
SAD-II: Oblique fracture of the medial malleolus; sequence of lateral fracture leading to medial fracture.

Supination External Rotation (SER) Stages

SER-I: Anterior Inferior Tibiofibular Ligament (AITFL) rupture or Tillaux-Chaput (tibia) / Wagstaffe (fibula) avulsion fracture.
SER-II: Spiral oblique fracture of the lateral malleolus at the ankle joint; classified as Danis-Weber B.
SER-III: Posterior Inferior Tibiofibular Ligament (PITFL) rupture or Volkmann's avulsion fracture of the posterior lip of the tibia.
SER-IV: Straight transverse fracture of the medial malleolus or deltoid ligament rupture; reflects the transition from lateral to medial injury.

Pronation Abduction (PAB) Stages

PAB-I: Straight transverse fracture of the medial malleolus or deltoid ligament rupture.
PAB-II: Rupture of both AITFL and PITFL without diastasis.
PAB-III: Straight oblique fracture of the lateral malleolus at the ankle joint; classified as Danis-Weber B.

Pronation External Rotation (PER) Stages

PER-I: Straight transverse fracture of the medial malleolus or deltoid ligament rupture.
PER-II: AITFL rupture accompanied by tibiofibular interosseous membrane tear (diastasis) or presence of Tillaux-Chaput / Wagstaffe fragments.
PER-III: Spiral oblique fracture of the fibula above the ankle joint; classified as Danis-Weber C.
PER-IV: Volkmann's avulsion fracture of the posterior lip of the tibia or rupture of the PITFL; indicates the progression of the injury.

Avulsion Fractures

Tillaux-Chaput Fracture: Occurs at the anterolateral tubercle of the tibia; associated with Lauge-Hansen classifications SER I, PAB II, and PER II.
Wagstaffe Fracture: Located at the anterior portion of the fibula; linked to Lauge-Hansen classifications SER I, PAB II, and PER II.
Volkmann's Fracture: Involves the posterior lip of the tibia; seen in classifications SER III and PER IV.

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Test your knowledge on the Danis-Weber and Lauge-Hansen fracture classifications with these flashcards. Understand the differences between Type A, B, and C fractures, as well as their relationships to syndesmotic injuries. This quiz is perfect for medical students and professionals looking to reinforce their understanding of fibular fractures.