Dr.Another shortcoming of the Lauge-Hansen classification lies in its failure to distinguish clearly between nonarticular posterior lip fractures and fractures that involve the articular surface, which entail the addition of axial loading for their production. Cemil Taşcıoğlu City Hospital, İstanbul, Turkeyĭepartment of Orthopedics and Traumatology, Prof. The Lauge-Hansen classification system may be insufficient to identify a medial ligament injury.ĭepartment of Orthopedics and Traumatology, Başakşehir Pine and Sakura City Hospital, İstanbul, Turkeyĭepartment of Orthopedics and Traumatology, Prof. This means that a medial malleolar fracture in bimalleolar fractures may be also accompanied by deltoid ligament injury. Postoperative medial clear space of 5 mm and higher was determined in 7 (18.9%) cases.Ĭonclusions: In SER type 4 bimalleolar fractures with a large medial malleolar fragment fracture, weight-bearing radiographs may show an increase in medial clear space. The postoperative medial clear space was 4.11 ± 0.57 mm. The preoperative tibiofibular overlap was 5.03 ± 2.93 mm, and the postoperative tibiofibular overlap was 8.62 ± 1.04 mm ( p = 0.001). The preoperative tibiofibular distance was 6.05 ± 1.86 mm, and the postoperative tibiofibular distance was 4.19 ± 0.40 mm ( p = 0.001). Results: The injury mechanism was sports injury in 17 (45.9%) cases, traffic accidents in 8 (21.6%) cases, falling in 9 (24.3%) cases, and falling from height in 3 (8.2%) cases. The data based on the evaluation of the weight-bearing radiographs of the patients taken in the postoperative 1st year were examined statistically. Thirty-seven cases (15 males and 22 females) were included in the study. Methods: The files of the patients who were operated with the diagnosis of SER type 4 bimalleolar ankle fracture between 2017-2020 were evaluated retrospectively. The aim of the study was to investigate medial insufficiency rates in postoperative weight-bearing radiographs in SER type 4 bimalleolar fractures. Objectives: According to the Lauge-Hansen classification, supination external-rotation (SER) type 4 fractures should be accompanied by medial malleolar fracture or deltoid ligament injury. Closed treatment of ankle fractures: stage II fractures followed twenty years. Supination-external rotation ankle fractures. Gougoulias N, Khanna A, Sakellariou A, Maffulli N. The use of weightbearing radiographs to assess the stability of supination-external rotation fractures of the ankle. Weber M, Burmeister H, Flueckiger G, Krause FG. Correlation of weightbearing radiographs and stability of stress positive ankle fractures. Hoshino CM, Nomoto EK, Norheim EP, Harris TG. Evaluation of the integrity of the deltoid ligament in supination external rotation ankle fractures: a systematic review of the literature. van den Bekerom MPJ, Mutsaerts ELAR, van Dijk CN. Analysis of radiographic classifications for rotational ankle fractures. Malreduction of the tibiofibular syndesmosis in ankle fractures. Gardner MJ, Demetrakopoulos D, Briggs SM, Helfet DL, Lorich, DG. Correlation between the Lauge-Hansen classification and ligament injuries in ankle fractures. Warner SJ, Garner MR, Hinds RM, Helfet DL, Lorich DG. X-ray features to predict ankle fracture mechanism.
Boszczyk A, Fudalej M, Kwapisz S, Błonski M, Kicinski M, Kordasiewicz B et al. Bimalleolar ankle fracture: a simple fracture? Acta Ortop Bras 2017 25:48-51. Fukuyama JM, Pires RES, Labronici PJ, Hungria JOS, Decusati RL. Competence of the deltoid ligament in bimalleolar ankle fractures after medial malleolar fixation. The Ability of the Lauge-Hansen classification to predict ligament injury and mechanism in ankle fractures: an MRI study. Gardner MJ, Demetrakopoulos D, Briggs SM, Helfet DL, Lorich DG. Compatibility of Lauge-Hansen classification between plain radiographs and magnetic resonance imaging in ankle fractures. Cabuk H, Celebi F, İmren Y, Dedeoğlu SS, Kır MC, Uyanık AF et al.
Classifications in brief: Lauge-Hansen classification of ankle fractures. Tartaglione JP, Rosenbaum AJ, Abousayed M, DiPreta JA. Does medial tenderness predict deep deltoid ligament incompetence in supination-external rotation type ankle fractures? J Orthop Trauma 2007 21:244-7. Managing type II and type IV Lauge-Hansen supination external rotation ankle fractures: current orthopaedic practice. Kosuge DD, Mahadevan D, Chandrasenan J, Pugh H.
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