Lauge-Hansen Classification of Ankle Fractures скачать в хорошем качестве

Lauge-Hansen Classification of Ankle Fractures

In this video, we review the Lauge-Hansen classification of ankle fractures, as described in Netter’s Concise Orthopaedic Anatomy. This system is based on the mechanism of injury, combining the position of the foot (supination or pronation) with the direction of the deforming force (external rotation, abduction, or adduction). The main patterns include: Pronation – External Rotation (PER): high oblique fibula fracture, often with medial malleolus or deltoid injury. Pronation – Abduction (PA): transverse or comminuted fibula fracture with medial structures involved. Supination – External Rotation (SER): oblique fibula fracture, the most common pattern, progressing through predictable stages I–IV. Supination – Adduction (SA): low transverse fibula fracture with vertical medial malleolus fracture. We also discuss the Weber/AO classification (A: distal, B: at the plafond, C: above plafond), and how it complements Lauge-Hansen. Clinical evaluation includes history of trauma, pain, swelling, inability to bear weight, and physical exam findings such as effusion, medial or lateral tenderness, and instability on stress radiographs. Treatment depends on fracture stability: Stable/nondisplaced injuries → short leg cast for 4–6 weeks. Unstable/displaced injuries → open reduction and internal fixation (ORIF), with restoration of the mortise and fibular length. Syndesmotic injuries may require fixation. Complications include posttraumatic arthritis, malunion, nonunion, chronic instability, and reflex sympathetic dystrophy.