The lateral collateral ligaments of the ankle (anterior/posterior tibilfibular ligaments, calcaneofibular ligaments) help to prevent inversion and anterior translation of the fibula. On the lateral side, the anterior inferior tibiofibular ligament, posterior inferior tibiofibular ligament and the inferior transverse ligament help to prevent eversion of the ankle. This classification system uses 2 words: the first. The joint is maintained by a variety of ligaments. Two main classification systems exist: Lauge-Hansen classification Danis and Webers classification (1991). The ankle is made up of articulations between the tibia, fibula and talus.
To begin, let's take a quick look at the anatomy of the ankle joint (picture below). Information is borrowed from this text and the Handbook of Fractures. As usual, I'm stealing my images from the AAOS Comprehensive Orthopaedic Review. I'm going to go through ankle fractures like I did with pelvic fractures and hopefully, in attempting to understand the LH classification, impart some knowledge on everyone else. The Weber classification is a little more straightforward, but doesn't impart as much information about the injury as the LH classification. The Kappa index was 0.49 for the Danis-Weber classification, 0.32 for Lauge Hansen, and 0.38 for AO. ‒ by Monica Jaramilloĭisclosures: The researchers report no relevant financial disclosures.For whatever reason, I have a difficult time wrapping my head around the Lauge-Hansen (LH) ankle fracture classification. The Danis-Weber classification indicated that 40 of the agreements among all observers were good or excellent, whereas only 20 of good and excellent agreements were obtained using the AO and Lauge Hansen classifications. The remaining 6% of ankle fractures had discrepancies because of a lack of anterior inferior ligament, according to researchers. Investigators noted the Lauge-Hansen classification of ankle fractures was associated with intraoperative findings, showing 94% of MRI findings for injuries and fracture patterns matched predictions with the Lauge-Hansen classification.
Of the 283 classified fractures, 266 had ligamentous injury MRI results and fracture patterns that were true to the predictions made using the Lauge-Hansen classification. Lauge-Hansen (published as Lauge N.) wrote a definitive review of ankle fractures ‘an analytic historic survey as the basis of new experimental, roentgenologic and clinical investigations‘ 2 years before his classification publication. Lauge-Hansen classifications showed 231 of ankle fractures were classified as supination external rotation, 40 fractures were classified as pronation external rotation, 11 were classified as supination adduction, one was classified as pronation abduction and 17 could not be classified. Niels Lauge-Hansen (1899 1976) was a Danish Radiologist. Investigators also used MRI scans to analyze deltoid and syndesmotic ligaments. Researchers studied 283 patients with an average age of 47.8 years who were surgically treated for ankle fracture and had radiographs to determine their Lauge-Hansen classification. If you continue to have this issue please contact to HealioĬomparisons made between injury radiographs, preoperative MRI scans and intraoperative results indicated the Lauge-Hansen classification can accurately predict ligament injuries in ankle fracture cases, according to study results.
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