Lauge-Hansen Classification

 

This classification scheme uses 2 words descriptors. The first word describes the position of the foot, the second word describes the motion of the foot (talus) with respect to the leg. Mentally image this as you learn the sequence staging.  And you can visualize these motions here: I stumbled across this video program while doing some research online for an upcoming presentation at my local hospital.  This video program provides a visual demonstration as to  the position of the foot as well as the mechanism of action during the ankle fractures described below.

 

 

Supination-Adduction

 

Stage 1: Transverse fracture of lateral malleolus, at or below the level of anterior talo-fibular ligament or a tear of lateral collateral ligament structures with the anterior talofibular ligament disrupted most often and frequently the calcaneofibular ligament also being torn.

Stage 2: Oblique fracture of medial malleolus

 

Supination-External (Eversion) Rotation


Stage 1: Rupture of anterior inferior tibiofibular ligament.
Stage 2: Oblique fracture or spiral fracture of the lateral malleolus.
Stage 3: Rupture of post tibiofibular ligament or fracture of posterior malleolus of tibia.
Stage 4: Transverse (sometimes oblique) fracture of Tibial malleolus.

(40% - 70% of all ankle fractures)


Pronation-Abduction


Stage 1: Rupture of the deltoid ligament or transverse fracture of the medial malleolus.
Stage 2: Rupture of the anterior and posterior inferior tibiotalofibular ligaments or bony avulsion.
Stage 3: Oblique fracture of the fibula at the level of the syndesmosis.

(Less than 5% of ankle fractures.)

 

Pronation-Eversion


Stage 1: Rupture of the deltoid ligament or transverse fracture of the medial malleolus.
Stage 2: Rupture of the anterior nferior tibiotalofibular ligaments or bony avulsion.
Stage 3: Spiral/Oblique fracture of the fibula above the level of the syndesmosis.
Stage 4: Rupture of the posterior inferior tibiofibular ligament or fracture of the posterior malleolus.


Pronation-Dorsiflexion


Stage 1: Fracture of the medial malleolus.
Stage 2: Fracture of the anterior lip of the tibial.
Stage 3: Fracture of the supramalleolar aspect of the fibula
Stage 4: Rupture of the posterior inferior tibiofibular ligament or fracture of the posterior malleolus.