Radiographic analysis of adult ankle fractures using combined Danis-Weber and Lauge-Hansen classification systems

Abstract

This study was to analyze ankle fractures for determining the epidemiology, types, distribution, possible mechanisms and diagnosis precision. Between January 2013 and December 2017, all Chinese patients older than 16 years of age with ankle fractures excluding old ankle fractures and pathological fractures in a tertiary care hospital were analyzed by using the Danis-Weber and Lauge-Hansen classification systems. Among 3952 patients with ankle fractures, 1225 fractures (31%) were Danis-Weber type A, 1640 (42%) were type B, 751 (19%) were type C, and 336 (9%) were perpendicular compression fracture. There were 1949 fractures on the left side and 2003 on the right with no significant difference (P > 0.05). Male patients between 16 and 50 years of age and women over 50 years had a higher incidence of ankle fractures accounting for 38.4% (1517/3952) and 22.2% (800/3952), respectively. Posterior malleolar fractures, fibular fractures above the inferior tibiofibular joint and Tillaux fractures were easily missed in the diagnosis, with 38 fractures (0.96%) being missed in the diagnosis. In conclusion, young and middle-aged men and older women have a higher incidence of ankle fractures, and use of the Lauge-Hansen and Danis-Weber classification systems can better help assessing the varied and complex ankle fractures, predicting the injuries, increasing diagnostic precision and decreasing misdiagnosis rate.

Application of X-ray image measurement in the early diagnosis of sports injury of ankle ligament

“…For Weber classification, types A, B, and C in this study accounted for 29%, 51%, and 10%, respectively, similar to those reported in the literature. 11 - 12 In 8% of cases, Weber classification was not possible because there was no fibula fracture. 105 cases were all cases of ankle sprains, of which 97 cases were able to make Lauge-Hansen classification, and eight cases were not able to perform Lauge-Hansen classification.…”

Favored location of a stabilizing screw for syndesmotic diastasis: Recommendation based on clinical and theoretical considerations

“…Therefore, until now a simple, complete, and convincing classi cation for ankle injuries has yet been established. In the literature, combined Weber and Lauge-Hansen classi cations are supported by many orthopedic surgeons [9][10][11]. They believe that the combined classi cations can comprise the majority of ankle injuries related to the malleoli and syndesmosis.…”

“…The causes of ankle injuries included motorcycle accident (27 cases), various sports injuries (11 cases), slide (8 cases), fall from stairs (6 cases), and various reasons (11 cases). Fifty-eight injuries were caused by loads from external rotation: 33 supination-external rotation and 25 pronation-external rotation (by Lauge-Hansen classi cation) [9][10][11]. Four cases were associated with type 2 or IIIA open fractures [15].…”

Favored location of a stabilizing screw for syndesmotic diastasis: Recommendation based on clinical and theoretical considerations

“…The causes of ankle injuries included motorcycle accident (27 cases), various sports injuries (11 cases), slide (8 cases), fall from stairs (6 cases), and other causes (11 cases). Fifty-eight injuries were caused by load-bearing during external rotation: 33 supination-external rotation and 25 pronation-external rotation (by Lauge-Hansen classi cation) [9][10][11]. Four cases were associated with type II or IIIA open fractures [15].…”

“…Until now, there is no universal classi cation of malleolar fractures with or without SD. In the literature, many orthopedic surgeons have described using the combined Weber and Lauge-Hansen classi cations [9][10][11]. They believe that the combined classi cations may cover the majority of ankle injuries that should not be ignored.…”