Functional outcome of surgical management of ankle fractures classified as per Lauge-Hansen classification
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20261210Keywords:
Supination-adduction syndesmotic injury, Pronation-abduction, ORIF, Supination-external rotation, Ankle fracture, Lauge-Hansen classificationAbstract
Background: Ankle fractures are one of the common types of fractures treated by orthopaedic surgeons. There has been an increase in the prevalence of such fractures over the last two decades both in the young and active patients and in the elderly. The Lauge-Hansen classification system, based on the mechanism of injury, remains one of the most widely used methods for categorizing ankle fractures. It divides fractures into four main types-supination-adduction (SA), supination-external rotation (SER), pronation-abduction (PA), and pronation-external rotation (PER)-based on the position of the foot at time of injury and the direction of the applied force. Ankle injuries gain importance because the whole-body weight is transmitted through the ankle and locomotion depends upon the stability of the ankle joint
Methods: The inclusion criterion included all those ankle fracture more than 18 years and who consent to participate. The operative procedure was performed within 4 to 5 days of the injury. A preoperative clinical examination of the affected ankle was carried in all aspects like- abrasions, swelling, contusion, puckering and neurovascular deficit. Antero posterior (AP) and lateral (Lat) and mortise radiographs of the patient were evaluated.
Results: Out of the thirty patients followed up to a minimum of 18 months in the study twenty-one were males and nine were females. The mean age was 41.3 years (range 18 to>50 years). Eighteen out of thirty patients (60%) had the right side fractured and remaining twelve out of thirty had a left sided fracture (40%). In terms of anatomical classification trimalleollar fractures constituted the majority of cases (n=17,56.7%), followed by brimalleolar fractures (n=13, 43.3%). Five patients (16.7%) had open fractures classified as Gustilo-Anderson grade I or II, while the remaining 25 (83.3% presented with closed injuries.
Conclusions: Surgical treatment of ankle fractures, guided by accurate classification and operative principles, leads to favorable outcomes. The Lauge-Hansen system remains useful for diagnosis, prognosis, and surgical planning. Further multicenter studies with extended follow-up are needed to optimize care for complex fracture types.
References
Goost H, Wimmer MD, Barg A, Kabir K, Valderrabano V, Burger C. Fractures of the ankle joint: investigation and treatment options. Dtsch Arztebl Int. 2014;111(21):377-88.
Krumbach B, Meretsky CR, Polychronis A, Schiuma AT. A Systematic Review of the Optimal Management of Pediatric Distal Radius Displacement Fractures: Open Reduction and Internal Fixation Versus Cast Placement. Cureus. 2024;16(8):e66696.
Wylie JD, Beckmann JT, Granger E, Tashjian RZ. Functional outcomes assessment in shoulder surgery. World J Orthop. 2014;5(5):623-33.
Chirayath A, Dhaniwala N, Kawde K. A Comprehensive Review on Managing Fracture Calcaneum by Surgical and Non-surgical Modalities. Cureus. 2024;16(2):e54786.
Shahid J, Kashif A, Shahid MK. A Comprehensive Review of Physical Therapy Interventions for Stroke Rehabilitation: Impairment-Based Approaches and Functional Goals. Brain Sci. 2023;13:5.
Özkan Y, Öztürk A, Özdemir R, Atıcı T, Özbölük S. The results of surgical management of ankle fractures. Ulus Travma Acil Cerrahi Derg. 2005;11(4):329-35.
Lauge-Hansen N. Fractures of the ankle. II. Combined experimental-surgical and experimental-roentgenologic investigations. Arch Surg. 1950;60(5):957-85.
Lauge-Hansen N. Fractures of the ankle. III. Genetic roentgenologic diagnosis of fractures of the ankle. Am J Roentgenol Radium Ther Nucl Med. 1954;71(3):456-71.
Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15(7):349-53.
Daly PJ, Fitzgerald RH Jr, Melton LJ, Ilstrup DM. Epidemiology of ankle fractures in Rochester, Minnesota. Acta Orthop Scand. 1987;58(5):539-44.
Court-Brown CM, McBirnie J, Wilson G. Adult ankle fractures-an increasing problem? Acta Orthop Scand. 1998;69(1):43-7.
Warner SJ, Garner MR, Schottel PC, Fabricant PD, Helfet DL, Lorich DG. Analysis of ankle fracture mechanisms using the Lauge-Hansen classification. J Orthop Trauma. 2015;29(12):e481-7.
Delaney RA, Hess EP, Vopat BG. Predictive value of Lauge-Hansen classification in ankle fractures. Foot Ankle Int. 2019;40(6):694-701.
Baird RA, Jackson ST. Fractures of the distal part of the fibula with associated disruption of the deltoid ligament. J Bone Joint Surg Am. 1987;69(9):1346-52.
Verhage SM, Schipper IB, Hoogendoorn JM. Long-term functional and radiographic outcomes in ankle fractures. Foot Ankle Surg. 2015;21(3):201-5.
Ovaska MT, Mäkinen TJ, Madanat R. Predictors of poor outcomes following deep infection after ankle fracture fixation. Injury. 2013;44(7):1002-6.
Schepers T. To retain or remove the syndesmotic screw: a review of literature. Arch Orthop Trauma Surg. 2011;131(7):879-83.
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