Lauge-Hansen classification of ankle injury

Dr Craig Hacking and Dr Amir Rezaee et al.

The Lauge-Hansen classification system is used for the classification of the ankle injuries based on the mechanism of injury which have predictable pattern and imaging findings. Along with the Weber classification, these systems are useful tools in describing and classifying ankle injuries.


The Lauge-Hansen system uses two word descriptors:

  • the first word describes the position of the foot at the time of injury (i.e. supination or pronation)
  • the second word describes the deforming force direction (i.e. abduction, adduction, or external rotation)

Based on these two factors at least 13 different patterns has been described:

  • supination-adduction
    • without medial malleolar fracture
    • with medial malleolar fracture (Weber A)
  • supination-external rotation: the most common form of injury (40-70%)
    • stage 1: the anteroinferior tibiofibular ligament is torn or avulsed
    • stage 2: the talus displaces and fractures the fibula in an oblique or spiral fracture, starting at the joint (Weber B)
    • stage 3: tear of the posteroinferior tibiofibular ligament or fracture posterior malleolus
    • stage 4: tear of the deltoid ligament or transverse fracture medial malleolus
  • pronation-abduction
    • stage 1: deltoid ligament disruption or transverse medial malleolus fracture
    • stage 2: posterior malleolus fracture
    • stage 3: oblique fibular fracture (Weber C)
  • pronation-external rotation
    • stage 1: deltoid ligament rupture, which may appear occult or as medial mortise widening, or fracture of the medial malleolus
    • stage 2: involvement of the AITFL with extension into the interosseous membrane results in widening of distal tibiofibular distance
    • stage 3: a spiral or oblique fibular fracture (>6 cm) at the level above the talotibial joint (Weber C) 
    •  stage 4: involvement of the PITFL, or posterior malleolus fracture 

See also

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rID: 39638
Tag: cases
Synonyms or Alternate Spellings:
  • The Lauge-Hansen classification of ankle injury

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