Assessing the prevalence of various modes of injury and type of malleolar fractures based on Lauge-Hansen classification presenting at a tertiary care center

Authors

  • Jairam D Jagiasi Department of orthopaedics, Dr. R. N. Cooper General hospital & HBT Medical college, Juhu, Vile Parle (W)
  • Mohit R. Upadhyaya Department of orthopaedics, Dr. R. N. Cooper General hospital & HBT Medical college, Juhu, Vile Parle (W)
  • Pranjal Rai Department of orthopaedics, Dr. R. N. Cooper General hospital & HBT Medical college, Juhu, Vile Parle (W)

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20203718

Keywords:

Malleolar fractures, Lauge-Hansen, Mode of injury

Abstract

Background: Ankle fractures represent approximately 9% of all fractures and are a common occurrence with an incidence of 138-169 per 100,000 per year. The mechanism of injury differs in terms of mode of injury in various age groups. The Lague-Hansen classification is a pathologic-anatomic classification and emphasizes different stages of ligamentous injury, in addition to the fracture pattern, and provides options for fracture treatment.

Methods: A retrospective observational study, where the prevalence of various types of ankle fractures were classified according to the Lauge-Hansen Classification, in the period of 2018 onwards till date. The mode of injury and age group of the patient was also noted.

Results: A total of 84 patients were analyzed, supination-external rotation (48.7%) were the most frequently observed fractures in our study population, with no significant correlation between mode of injury and fracture pattern noted. There was a statistically significant association (p<0.05) between the velocity of injury and the age groups suffering ankle trauma.

Conclusion: The Lauge-Hansen Classification continues to be an important tool in assessing the biomechanics of ankle fractures and the management options available, especially in a country like India where more expensive imaging modalities may not be available or affordable at times. Our study also highlights that high velocity fractures continue to be a major cause of morbidity in the younger age group, especially in developing countries such as India. Stringent traffic rules and public awareness need to be put into practice to reduce the toll of this problem.

Author Biographies

Jairam D Jagiasi, Department of orthopaedics, Dr. R. N. Cooper General hospital & HBT Medical college, Juhu, Vile Parle (W)

Additional Professor, Department of orthopedics

Mohit R. Upadhyaya, Department of orthopaedics, Dr. R. N. Cooper General hospital & HBT Medical college, Juhu, Vile Parle (W)

specialty medical officer,

department of orthopedics

Pranjal Rai, Department of orthopaedics, Dr. R. N. Cooper General hospital & HBT Medical college, Juhu, Vile Parle (W)

intern

References

Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37(8):691-7.

Court-Brown CM, Biant L, Bugler KE, McQueen MM. Changing epidemiology of adult fractures in Scotland. Scottish medical journal. 2014;59(1):30-4.

Elsoe R, Ostgaard SE, Larsen P. Population-based epidemiology of 9767 ankle fractures. Foot Ankle Surg. 2018;24(1):34-9.

Lauge-Hansen N. Fractures of the ankle: II. Combined experimental-surgical and experimental-roentgenologic investigations. Archives Surg. 1950;60(5):957-85.

Weber BG. Die Verletzungen des oberen sprunggelenkes. Bern. Switzerland: Huber Verlag. 1972.

Müller ME, Nazarian S, Koch P, Schatzker J. The comprehensive classification of fractures of long bones. Springer Science & Business Media; 2012.

Fonseca LL, Nunes IG, Nogueira RR, Martins GE, Mesencio AC, Kobata SI. Reproducibility of the Lauge-Hansen, Danis-Weber, and AO classifications for ankle fractures. Rev Bras Ortop. 2018;53(1):101-6.

Alexandropoulos C, Tsourvakas S, Papachristos J, Tselios A, Soukouli P. Ankle fracture classification: An evaluation of three classification systems: Lauge-Hansen, AO and Broos-Bisschop. Acta Orthop Belg. 2010;76(4):521.

Verhage SM, Rhemrev SJ, Keizer SB, van Ufford HQ, Hoogendoorn JM. Interobserver variation in classification of malleolar fractures. Skelet Radiol. 2015;44(10):1435-9

Gardner MJ, Demetrakopoulos D, Briggs SM, Helfet DL, Lorich DG. The ability of the Lauge-Hansen classification to predict ligament injury and mechanism in ankle fractures: an MRI study. J Orthop Trauma. 2006;20(4):267-72.

Lindsjö U. Classification of ankle fractures: the Lauge-Hansen or AO system?. Clin Orthop Relat Research. 1985;(199):12-6.

Nielsen JØ, Dons-Jensen H, Sørensen HT. Lauge-Hansen classification of malleolar fractures: an assessment of the reproducibility in 118 cases. Acta Orthop Scand. 1990;61(5):385-7.

Rasmussen S, Madsen PV, Bennicke K. Observer variation in the Lauge-Hansen classification of ankle fractures: precision improved by instruction. Acta Orthop Scand. 1993;64(6):693-4.

Thomsen NO, Overgaard S, Olsen LH, Hansen H, Nielsen ST. Observer variation in the radiographic classification of ankle fractures. J Bone Jt Surg. British volume. 1991;73(4):676-8.

Boszczyk A, Fudalej M, Kwapisz S, Klimek U, Maksymowicz M, Kordasiewicz B, Rammelt S. Ankle fracture—Correlation of Lauge-Hansen classification and patient reported fracture mechanism. Forensic science international. 2018;282:94-100.

Viberg B, Haidari TA, Stork-Hansen J, Knudsen R, Bech RD. Reproducibility of the stability-based classification for ankle fractures. European Journal of Orthopaedic Surgery & Traumatology. 2019;29(5):1125-9.

Briet JP, Houwert RM, Smeeing DP, Dijkgraaf MG, Verleisdonk EJ, Leenen LP, Hietbrink F. Differences in classification between mono-and polytrauma and low-and high-energy trauma patients with an ankle fracture: a retrospective cohort study. J Foot Ankle Surg. 2017;56(4):793-6.

Downloads

Published

2020-08-26

Issue

Section

Original Research Articles