Reproducibility of the Lauge-Hansen, Danis-Weber, and AO classifications for ankle fractures.

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Abstract

20. Foot Ankle Int. 2024 May;45(5):446-455. doi: 10.1177/10711007241231563. Epub 2024 Mar 19. Temporary Cast Application in Dislocated Ankle Fractures Leads to High Rates of Secondary Loss of Reduction: Does the Lauge-Hansen Injury Type Matter? Mandelka E(1), Wikanardi BA(1)(2), Beisemann N(1), Gruetzner PA(1), Franke J(1), Vetter SY(1). Author information: (1)BG Trauma Center Ludwigshafen, Department of Trauma and Orthopedic Surgery, Ludwigshafen, Germany. (2)University of Heidelberg, Medical Faculty Heidelberg, Heidelberg, Germany. BACKGROUND: For the temporary treatment of ankle fracture dislocations (AFDs), previous studies indicate higher rates of secondary loss of reduction (LOR) with splint immobilization, prompting consideration for expanding indications for external fixation (ExFix). However, these studies did not investigate the influence of fracture morphology to further improve patient selection. The aim of this study was to investigate the influence of Lauge-Hansen injury type on the LOR rate in bimalleolar or trimalleolar AFDs for temporary cast vs ExFix immobilization. METHODS: In this retrospective cohort study, patients with isolated AFD cases treated at our institution from 2011 to 2020 were reviewed. Inclusion criteria required radiographs depicting initial dislocation and appropriate reduction after Cast or ExFix immobilization. Exclusion criteria encompassed concomitant injuries, open fractures, conservative management as well as surgery performed within 48 hours or at a different facility. Patients were grouped by temporary treatment (Cast or ExFix). The primary endpoint was LOR prior to definitive surgery across various Lauge-Hansen types. RESULTS: The LOR rate was significantly higher in the cast group (40/152, 26.3%) compared to the ExFix group (5/191, 2.6%; P