UCSD Musculoskeletal Radiology bonepit.com 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.  Medial displacement of talus on tibia.

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.

  
Stage 3: Rupture of post tibiofibular ligament or fracture of posterior malleolus of tibia.
Stage 4: Transverse (sometimes oblique) fracture of Tibial malleolus.

40M      

19M        

Pronation-Abduction  Less than 5% of ankle fractures.

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

34M   
Stage 3: Oblique/transverse fracture of the fibula at the level of the syndesmosis.

32M    

Pronation-Eversion

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.