title: Correlation Between the Lauge-Hansen Classification and Ligament Injuries in Ankle Fractures.
abstract: OBJECTIVE
  To evaluate the ability of the Lauge-Hansen classification to predict ligament injuries in ankle fractures using magnetic resonance imaging (MRI) and intraoperative findings.
  
  
  METHODS
  Prospective evaluation in consecutive patients.
  
  
  METHODS
  Academic level 1 trauma center.
  
  
  METHODS
  Three-hundred patients with an operatively treated ankle fracture who met the inclusion and exclusion criteria.
  
  
  METHODS
  Injury ankle radiographs were assigned to a Lauge-Hansen classification. MRI scans were obtained to evaluate the syndesmotic and deltoid ligaments. A Lauge-Hansen classification for each patient was recorded based on intraoperative findings.
  
  
  METHODS
  Comparisons were made between the predicted ankle ligamentous injuries based on radiographic Lauge-Hansen classifications, preoperative MRI analyses, and intraoperative findings.
  
  
  RESULTS
  On the basis of the Lauge-Hansen system and injury radiographs, 77% (231/300) were classified as supination external rotation, 13% (40/300) were pronation external rotation, 4% (11/300) were supination adduction, <1% (1/300) was pronation abduction, and 6% (17/300) were not classifiable. Of the 283 fractures that were classified into Lauge-Hansen classes, 266 (94%) had MRI readings of ligamentous injuries consistent with the Lauge-Hansen predictions. Intraoperative findings also highly correlated with the Lauge-Hansen class of ankle fractures, with nearly complete agreement. Comparing MRI and intraoperative findings revealed discrepancies in 6% (16/283) of ankle fracture classifications.
  
  
  CONCLUSIONS
  In our large cohort of patients, comparisons between injury radiographs, preoperative MRI, and intraoperative findings suggest that the Lauge-Hansen system is an accurate predictor of ligamentous injuries. The predictions based on the Lauge-Hansen system can be useful for fracture reduction maneuvers and operative planning.
  
  
  METHODS
  Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY; and †Orthopaedic Trauma Service, Hospital for Special Surgery and Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Warner
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Garner
authors.forename: Richard M
authors.initials: RM
authors.lastname: Hinds
authors.forename: David L
authors.initials: DL
authors.lastname: Helfet
authors.forename: Dean G
authors.initials: DG
authors.lastname: Lorich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D064386:Ankle Fractures / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008022:Ligaments / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D010808:Physical Examination / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000706:statistics & numerical data; D055815:Young Adult