![]() ![]() We hypothesized that the combination of the Danis-Weber and Lauge-Hansen classification systems could be used to investigate the patterns of ankle fractures and patterns which might be easily misdiagnosed and to guide clinical treatment. This classification does not consider the state of the structures on the medial side, either, and it is impossible to compare prognosis or evolution 12, 13. This classification system is simple and easy of reproduction, however, it does not consistently predict the scope of injury in the tibiofibular syndesmosis since types B and C can be managed in a similar approach regardless of location of fracture. The Danis-Weber classification system was proposed by Danis and Weber according to the location of the primary fibular fracture line, with the fractures being divided into three groups: type A (below the syndesmosis level), type B (at the syndesmosis) and type C (above the syndesmosis) 5. Combination of the Lauge-Hansen classification system with the Danis-Weber system would make clinical application easier. However, it also has one disadvantage of complexity for routine use in daily life in the hospital 11. This classification can be used to accurately diagnose the range of injury, identify associated ligament injuries and determine the severity of the injury as well as the degree of instability. The Lauge-Hansen classification system indicates that the most frequent type is the supination-external rotation pattern with a prevalence of 40%-75% of all emergency ankle fractures. The first term specifies the position of foot at injury and the second indicates the direction of the force applied to the foot at injury 5. Through cadaver experiments, Lauge-Hansen suggested a classification system which correlates the lines of ankle fractures with specific traumatic mechanisms 10, with the fractures being classified into four groups: supination-adduction, supination-external rotation, pronation-external rotation, and pronation-abduction. However, this classification does not distinguish unstable and stable injuries even though it is intuitive and easy to reproduce. Ankle fractures were firstly classified as unimalleolar, bimalleolar or trimalleolar 5, 9. There are several types of classification for ankle fractures. Evaluation of ankle fractures mandates detailed history of disease, physical examination, proper radiographic examination and initial treatment choices, and successful treatment lies in correct diagnosis of this fracture followed by anatomical restoration of the bone structures involved for tibiotalar joint reconstruction. Treatment of the ankle fracture depends on careful recognition of the range of bone injuries and damage to the soft tissue and ligaments. Ankle fracture is one of the commonest injuries treated by orthopedic surgeons, accounting for 9% of all fractures and 36% of all lower extremity fractures in the United States, and the rate is still increasing particular among elder citizens because of ageing-associated increases in fragility fractures 7, 8. Ankle fracture is a common injury with recent studies demonstrating an annual incidence of 120ā150 fractures per 100,000 persons 6. The unique pattern of anatomy of the ankle and the functional relationship with the foot make the ankle highly susceptible to injuries 1, 2, 3, 4, 5. ![]() In conclusion, young and middle-aged men and older women have a higher incidence of ankle fractures, and use of the Lauge-Hansen and Danis-Weber classification systems can better help assessing the varied and complex ankle fractures, predicting the injuries, increasing diagnostic precision and decreasing misdiagnosis rate. Posterior malleolar fractures, fibular fractures above the inferior tibiofibular joint and Tillaux fractures were easily missed in the diagnosis, with 38 fractures (0.96%) being missed in the diagnosis. ![]() Male patients between 16 and 50 years of age and women over 50 years had a higher incidence of ankle fractures accounting for 38.4% (1517/3952) and 22.2% (800/3952), respectively. There were 1949 fractures on the left side and 2003 on the right with no significant difference (Pā>ā0.05). Among 3952 patients with ankle fractures, 1225 fractures (31%) were Danis-Weber type A, 1640 (42%) were type B, 751 (19%) were type C, and 336 (9%) were perpendicular compression fracture. Between January 2013 and December 2017, all Chinese patients older than 16 years of age with ankle fractures excluding old ankle fractures and pathological fractures in a tertiary care hospital were analyzed by using the Danis-Weber and Lauge-Hansen classification systems. This study was to analyze ankle fractures for determining the epidemiology, types, distribution, possible mechanisms and diagnosis precision. ![]()
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