Classification and treatment of ankle fractures.

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Abstract

10. J Foot Ankle Surg. 2022 Nov-Dec;61(6):1251-1254. doi: 10.1053/j.jfas.2022.02.013. Epub 2022 Feb 27. Does the Lauge-Hansen Injury Mechanism Predict Posterior Malleolar Fracture Morphology? Patton BK(1), Orfield NJ(1), Clements JR(2). Author information: (1)Carilion Clinic Department of Orthopaedic Surgery, Roanoke, VA. (2)Carilion Clinic Department of Orthopaedic Surgery, Roanoke, VA; Virginia Tech Carilion School of Medicine, Roanoke, VA. Electronic address: jrclements@carilionclinic.org. The Lauge-Hansen ankle fracture classification system is widely accepted and is utilized to describe and predict ankle fracture patterns based on the mechanism of injury. Multiple studies have shown inconsistencies in the Lauge-Hansen's ability to predict fracture patterns based on the mechanism of injury. We set out to determine if the posterior malleolar fracture pattern is associated with the fracture types described by Lauge-Hansen. In this retrospective cohort study, we reviewed 153 patients with trimalleolar ankle fractures as diagnosed using computed tomography scans. Timing of injury was from February 2013 to August 2017. Patient ages ranged between 18 and 89 years old. Each patient had a complete clinical and radiographic workup including a preoperative computed tomographic scan following initial fracture reduction in the emergency room. We classified each ankle fracture based on plain film radiographs using the Lauge-Hansen classification scheme. Each individual posterior malleolar fracture was evaluated on computed tomography imaging and described using both the Haraguchi and Bartonicek-Rammelt classification systems. Of the 153 patients identified with trimalleolar ankle fractures, 70% were female (±20%), the mean age was 51 y (±8 y), and the mean body mass index was 30 kg/m2 (±3 kg/m2). We did not observe a significant association between the Lauge-Hansen injury mechanism and either the Bartonicek-Rammelt or the Haraguchi trimalleolar ankle fracture classification systems (chi-square correlation tests p > .05). Copyright © 2022 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved. DOI: 10.1053/j.jfas.2022.02.013