Ankle Fracture Classification Systems: A Case for Integration of the Lauge-Hansen and AO-Danis-Weber Schemes

The two dominant classification systems for ankle fractures in use are the Lauge-Hansen and AO-Danis-Weber schemes. Each has certain advantages and disadvantages. Because of basic similarities, integration of these systems into one scheme involving three basic patterns with appropriate staging appears to be reasonable. This integration is based upon combining the pronation-abduction and pronation-external rotation injuries in Lauge-Hansen's scheme into one pronation-abduction-external rotation pattern. The resultant system would appear attractive in terms of combining relative simplicity with completeness.

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Superficial Peroneal Nerve Incarceration in the Fibular Fracture Site of a Pronation External Rotation Type Ankle Fracture

The Open Orthopaedics Journal ◽

10.2174/1874325001509010214 ◽

2015 ◽

Vol 9 (1) ◽

pp. 214-217 ◽

Cited By ~ 1

Author(s):

P Ellanti ◽

K.M.S Mohamed ◽

K O’Shea

Keyword(s):

Ankle Fracture ◽

Peroneal Nerve ◽

External Rotation ◽

Fracture Site ◽

Ankle Fractures ◽

Posterolateral Approach ◽

Unexpected Finding ◽

Superficial Peroneal Nerve ◽

Fibular Fracture ◽

Pronation External Rotation

Ankle fractures are common representing up to 10% of all fractures with an incidence that is rising. Both conservative treatment and operative management of ankle fractures can lead to excellent outcomes. Neurovascular injuries are uncommon but can be a source of significant morbidity and associated poor outcome. The superficial peroneal nerve (SPN) in the lateral approach and the sural nerve in the posterolateral approach are at risk of injury. We report an unexpected finding of a superficial peroneal nerve incarcerated in the fibular fracture site of pronation external rotation type/ Weber-C ankle fracture. To the best of our knowledge we believe this to be the first English language report of an incarcerated SPN at a fibular ankle fracture site.

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Suture button versus syndesmosis screw fixation in pronation-external rotation ankle fractures: A minimum 6-year follow-up of a randomised controlled trial

Injury ◽

10.1016/j.injury.2021.06.025 ◽

2021 ◽

Author(s):

Ristomatti Lehtola ◽

Hannu-Ville Leskelä ◽

Tapio Flinkkilä ◽

Harri Pakarinen ◽

Jaakko Niinimäki ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Screw Fixation ◽

External Rotation ◽

Controlled Trial ◽

Ankle Fractures ◽

Suture Button ◽

Randomised Controlled ◽

Syndesmosis Screw ◽

Pronation External Rotation

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Ankle Fracture Classification: A Comparison of Reliability of Three X-ray Views Versus Two

Foot & Ankle International ◽

10.1177/107110079801900809 ◽

1998 ◽

Vol 19 (8) ◽

pp. 555-562 ◽

Cited By ~ 26

Author(s):

Michael E. Brage ◽

Matthew Rockett ◽

Robert Vraney ◽

Robert Anderson ◽

Alicia Toledano

Keyword(s):

Ankle Fracture ◽

Ankle Injury ◽

Ankle Fractures ◽

Kappa Statistics ◽

Fracture Classification ◽

X Ray ◽

Good Accord ◽

Interexaminer Reliability ◽

Intraexaminer Reliability ◽

Good Agreement

Our hypothesis was that malleolar ankle fractures could be classified with two radiographic views as reliably as with three views. Four different observers independently evaluated 99 sets of ankle radiographs. The examiners classified the ankle fractures by using both the Lauge-Hansen and Danis-Weber systems. The interobserver and intraobserver variations were analyzed by kappa statistics. With regard to intraexaminer reliability, the examiners demonstrated excellent accord in classifying the fractures in the Danis-Weber system with either three views or two views. The kappa values were comparable. In the Lauge-Hansen system, three examiners demonstrated excellent accord and one examiner demonstrated good accord in classifying the fractures. Similar kappa values were generated when examiners classified fractures with either three views or two views. With regard to interexaminer reliability, good to excellent accord was demonstrated overall among the four examiners when they used the Danis-Weber system with either three views or two views. The examiners were in good agreement when they used the Lauge-Hansen system. Similar kappa values were generated whether the examiners used three views or two views. Three radiographic views are usually ordered for evaluation of an acute ankle injury. Previous studies have shown that only two views are needed for diagnosis of a malleolar ankle fracture. This study demonstrates that malleolar ankle fractures can be classified with two views, lateral or mortise, with a reliability as good as that achieved with three views. The best agreement is achieved with lateral and mortise views.

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