Does the Lauge-Hansen Injury Mechanism Predict Posterior Malleolar Fracture Morphology?

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Abstract

11. Forensic Sci Int. 2018 Jan;282:94-100. doi: 10.1016/j.forsciint.2017.11.023. Epub 2017 Nov 21. Ankle fracture - Correlation of Lauge-Hansen classification and patient reported fracture mechanism. Boszczyk A(1), Fudalej M(2), Kwapisz S(3), Klimek U(4), Maksymowicz M(5), Kordasiewicz B(6), Rammelt S(7). Author information: (1)Department of Traumatology and Orthopaedics, Centre of Postgraduate Medical Education, Prof. Adam Gruca Clinical Hospital, Konarskiego Str. 13, 05-400 Otwock, Poland. Electronic address: ortopeda@boszczyk.pl. (2)Forensic Medicine Department, Medical University of Warsaw, Wojciecha Oczki Str. 1, 00-001 Warsaw, Poland. Electronic address: marcin_zms@wp.pl. (3)Department of Traumatology and Orthopaedics, Centre of Postgraduate Medical Education, Prof. Adam Gruca Clinical Hospital, Konarskiego Str. 13, 05-400 Otwock, Poland. Electronic address: skwapisz@gmail.com. (4)Department of Traumatology and Orthopaedics, Centre of Postgraduate Medical Education, Prof. Adam Gruca Clinical Hospital, Konarskiego Str. 13, 05-400 Otwock, Poland. Electronic address: urszula.u.klimek@gmail.com. (5)Department of Traumatology and Orthopaedics, Centre of Postgraduate Medical Education, Prof. Adam Gruca Clinical Hospital, Konarskiego Str. 13, 05-400 Otwock, Poland. Electronic address: maksymowicz.mm@gmail.com. (6)Department of Traumatology and Orthopaedics, Centre of Postgraduate Medical Education, Prof. Adam Gruca Clinical Hospital, Konarskiego Str. 13, 05-400 Otwock, Poland. Electronic address: bartekko@tlen.pl. (7)University Center for Orthopaedics & Traumatology, University Hospital, Carl Gustav Carus at the TU Dresden, Fetscherstrasse 74, Dresden 01307, Germany. Electronic address: Stefan.rammelt@uniklinikum-dresden.de. INTRODUCTION: The genetic Lauge-Hansen classification is used for reconstruction of the mechanism of ankle injury. In this study, we addressed the question of agreement between the mechanism of the fracture as postulated by the Lauge-Hansen classification and mechanism reported by the patient in rotational ankle fractures. MATERIAL AND METHODS: Radiographs of 78 patients with acute malleolar fractures were analyzed and compared with fracture mechanisms reported by these patients. RESULTS: The patient reported mechanisms were in concordance with the mechanism deducted from the X-rays in 49% of cases. Only 17% of patients who recalled a pronation trauma actually had radiographs classified as pronation fractures while 76% of patients who recalled a supination trauma were also radiographically classified as having sustained supination type fractures. CONCLUSION: The Lauge-Hansen classification should be used with caution for determining the actual mechanism of injury as it was able to predict the patient reported fracture mechanism in less than 50% of cases. A substantial percentage of fractures appearing radiographically as supination type injuries may have been actually produced by a pronation fracture mechanism. Copyright © 2017 Elsevier B.V. All rights reserved. DOI: 10.1016/j.forsciint.2017.11.023