Malleolar Fractures

History: Middle aged male with ankle pain. 

Lauge Hansen SER IV – Ankle mortise view shows fracture of the medial malleolus (yellow arrow) and a spiral fracture of the lateral malleolus (red arrow) which extends to the medial cortex of the fibula (green arrow). This is a Lauge Hansen supination external rotation type IV injury (the posterior malleolus fracture was noted on the lateral view).

Malleolar fractures are classified mainly by two classification systems, the Weber system and the Lauge-Hansen system. There are three main types of Weber fractures (A,B, and C). The Lauge-Hansen system is much more complex and divides the fractures into their mechanisms, including supination/adduction, supination/external rotation, pronation/abduction, and pronation/external rotation. An excellent illustration of these classification systems can be found here.

Read more about ankle fractures here.