![]() ![]() ResultsĪverage patient age was 59 (range: 18 to 84) years. These were then compared to the actual injured structures on MRI in each case, and the ability of the Lauge-Hansen system to accurately predict the complete injury pattern was determined for the entire cohort. Main Outcome MeasurementsĪfter evaluation of the x-rays, fractures were classified according to the system of Lauge-Hansen, and the predicted presence, sequence, and mechanism of injury was determined. MRI studies were subsequently read by an MRI musculoskeletal radiologist for the integrity of the ankle ligaments. All plain x-rays were assigned to a Lauge-Hansen category by an experienced orthopedic traumatologist. InterventionĪll patients had a standard 3-view ankle x-ray series before fracture reduction, followed by an MRI. Patientsįifty-nine patients with operative ankle fractures who were evaluated with both x-ray and MRI were included. The purpose of this study was to evaluate the accuracy of these predicted injury sequences using magnetic resonance imaging (MRI) in a series of patients with ankle fractures. 2008 Dec 13(4):593-610.The Lauge-Hansen classification system was designed to predict the mechanism and ligament injury patterns of ankle fractures on the basis of x-rays. A 1 mm lateral talar shift causes loss of joint surface contact by 42% -> chronic arthritis complications Operative repair depends on talar stability under tibial plafond.To diagnose deltoid ligament instability, use “gravity stress” view (lateral portion of ankle rests on xray table to increase medial mortise).Stage 3: Spiral oblique fibula fx above ankle mortise.Typically fibula fx has butterfly segment (comminuted).Stage 3: Transverse fibula fx at or above ankle mortise.Stage 1: Transverse MM fx (or deltoid ligament tear).Associated with syndesmosis instability.Stage 1: Low avulsion LM fx or lateral ligament injury.Stage 4: Transverse MM fx or deltoid ligament tear.Stage 2: Spiral oblique distal fibula fx at ankle mortise level.* Often fibula fx pattern hints at classification Supination-External Rotation (SER) ![]() Medial malleolus (MM) fx, or deltoid ligament tear.Posterior malleolus (PM) fx, or posterior talofibular ligament (PTFL) tear.Anterior talofibular ligament (AFTL) tear. ![]()
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