Ankle fracture classification systems: a case for integration of the Lauge-Hansen and AO-Danis-Weber schemes.

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Abstract

[Indexed for MEDLINE] 11. J Foot Ankle Surg. 2014 Jul-Aug;53(4):434-9. doi: 10.1053/j.jfas.2014.03.015. Epub 2014 May 1. Evaluation of Lauge-Hansen designation of Weber C fractures. Hinds RM(1), Schottel PC(2), Berkes MB(3), Little MT(4), Helfet DL(5), Lorich DG(6). Author information: (1)Research Fellow, Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY. Electronic address: RichardHindsResearch@gmail.com. (2)Orthopaedic Resident, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY. (3)Orthopaedic Surgeon, United States Air Force, Landstuhl Regional Medical Center, Landstuhl, Germany. (4)Orthopaedic Trauma Fellow, Harborview Medical Center, Seattle, WA. (5)Director, Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY. (6)Associate Director, Orthopaedic Trauma Service, Hospital for Special Surgery and New York Presbyterian Hospital, New York, NY. Associations between Weber C ankle fractures and pronation external rotation (PER) injuries of the Lauge-Hansen classification have often been incorrectly correlated. The purpose of the present study was to evaluate the Lauge-Hansen designation of Weber C fractures by establishing the proportion of Weber C fractures that are supination external rotation (SER), supination adduction (SA), pronation abduction (PA), PER, and hyperplantarflexion variant fractures. A clinical database of operative ankle fractures treated by the senior author (D.G.L.) was reviewed. The inclusion criteria were patient age older than 16 years, preoperative ankle radiographs, and Weber C fracture designation. A total of 132 patients met the inclusion criteria, and the proportion of PA, PER, SER, SA, and variant fractures among the Weber C fractures was analyzed. PA fractures accounted for 0.8% (n = 1), PER fractures 56.8% (n = 75), SER fractures 35.6% (n = 47), and hyperplantarflexion variant fractures 6.8% (n = 9) of the 132 Weber C fractures. Patients with Weber C-PER fractures were more commonly male (p = .005) and younger (p = .003) and demonstrated a greater fibular fracture height (p