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Back| Classification | Characteristics | Degree |
|---|---|---|
| Supination-Adduction Type | "Supination" refers to the position of the foot at the time of injury, with the sole facing forward and inward; "Adduction" refers to the direction of force, with the talus being strongly adducted within the ankle mortise, causing traction on the lateral side of the ankle and compression on the medial malleolus by the talus. | Degree I: Lateral ligament tear or avulsion fracture of the lateral malleolus |
| Degree II: Degree I with medial malleolus fracture, fracture line extending obliquely upward from the inner upper corner of the ankle mortise | ||
| Supination-External Rotation Type | The most common type of injury. "Supination" has the same meaning as above; "External Rotation" refers to the talus being subjected to external rotational stress within the ankle mortise, rotating outward and backward around the medial side, impacting the lateral malleolus and causing it to dislocate posteriorly and laterally. | Degree I: Anterior inferior tibiofibular ligament tear |
| Degree II: Degree I with fracture line at the level of the inferior tibiofibular connection, extending from anteroinferior to posterosuperior | ||
| Degree III: Degree II with posterior inferior tibiofibular ligament tear or posterior malleolus fracture | ||
| Degree IV: Degree III with deltoid ligament rupture or medial malleolus fracture | ||
| Pronation-Abduction Type | "Pronation" refers to the position of the foot at the time of injury, with the sole facing backward/outward; "Abduction" refers to the direction of force, with the talus being strongly abducted or everted, causing traction on the medial structures of the ankle and compression on the lateral malleolus. | Degree I: Medial malleolus fracture or deltoid ligament rupture |
| Degree II: Degree I with anterior and posterior inferior tibiofibular ligament rupture or fracture of the tibial anterior tubercle or posterior malleolus | ||
| Degree III: Degree II with oblique or butterfly fracture of the lateral malleolus at or slightly above the level of the inferior tibiofibular connection | ||
| Pronation-External Rotation Type | "Pronation" has the same meaning as above; "External Rotation" refers to the talus being subjected to external rotational stress, causing initial damage to the medial structures of the ankle and loss of stability, with the talus rotating outward and anteriorly around the lateral side. | Degree I: Medial malleolus fracture or deltoid ligament rupture |
| Degree II: Degree I with anterior inferior tibiofibular ligament rupture | ||
| Degree III: Degree II with oblique or spiral fracture of the lateral malleolus 6-10cm above the level of the inferior tibiofibular connection | ||
| Degree IV: Degree III with posterior inferior tibiofibular ligament rupture or posterior malleolus fracture |
Explanation
In 1952, Danish doctor Lauge-Hansen classified ankle fractures and dislocations based on the position of the injured foot at the time of injury and the direction of the force causing the injury, using cadaver dissections and clinical observations. Each classification is further divided into degrees based on the extent of bone and ligament damage.
Some ankle fractures and dislocations are mild, and closed reduction with external fixation can achieve satisfactory results. For supination-adduction, supination-external rotation, or mildly displaced pronation-type fractures and dislocations, manual reduction is preferred, with surgery only if X-rays show poor positioning.
The Lauge-Hansen classification emphasizes the importance of ligament injuries in addition to fractures, highlighting the direction of force, and the sequence of bone and ligament injuries during ankle trauma. It comprehensively reflects the impact on ankle stability, clarifies the injury mechanism and trauma pathology, and involves ankle ligaments, providing practical guidance for treatment.
