UCSD Musculoskeletal Radiology

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MSK Classifications

Lauge-Hansen Classification              

This classification scheme uses 2 words descriptors. The first word describes the position of the foot, the second word describes the motion of the foot (talus) with respect to the leg.

Supination-Adduction

Stage 1: Transverse fracture of lateral malleolus, at or below the level of anterior talo-fibular ligament or a tear of lateral collateral ligament structures with the anterior talofibular ligament disrupted most often and frequently the calcaneofibular ligament also being torn.

35M

    51M

 

Stage 2: Oblique/vertical fracture of medial malleolus.

  46M

 

 

Supination-External (Eversion) Rotation  40% - 70% of all ankle fractures.

Stage 1: Rupture of anterior inferior tibiofibular ligament.

  23M


Stage 2: Oblique fracture or spiral fracture of the lateral malleolus. Superoposterior to anteroinferior.

   

   

  


Stage 3: Rupture of posterior inferior tibiofibular ligament or fracture of posterior malleolus of tibia.


Stage 4: Transverse (sometimes oblique) fracture of Tibial malleolus, or deltoid ligament rupture.

   

 

   

      40M

        19M

 

 

 

 

Pronation-Abduction (eversion) Less than 5% of ankle fractures.

Stage 1: Rupture of the deltoid ligament or low transverse fracture of the medial malleolus.
Stage 2: Rupture of the anterior and posterior inferior tibiofibular ligaments or bony avulsion.

     34M


Stage 3: Oblique/transverse fracture of the fibula at the level of the syndesmosis.

    32M

 

 

 

Pronation-External rotation

Stage 1: Rupture of the deltoid ligament or transverse fracture of the medial malleolus.


Stage 2: Rupture of the anterior inferior tibiotalofibular ligaments or bony avulsion.

   34M


Stage 3: Spiral/Oblique fracture of the fibula above the level of the syndesmosis.

 

              35M


Stage 4: Rupture of the posterior inferior tibiofibular ligament or fracture of the posterior malleolus.

 

 

Maisonneuve Fracture

51M        

59M        

 

 

Pronation-Dorsiflexion

Stage 1: Fracture of the medial malleolus.


Stage 2: Fracture of the anterior lip of the tibia.


Stage 3: Fracture of the supramalleolar aspect of the fibula


Stage 4: Rupture of the posterior inferior tibiofibular ligament or fracture of the posterior malleolus.