Lauge-Hansen N: Fractures of the ankle. II. Combined experimental-surgical and experimental-roentgenologic investigations. Arch Surg 60 : 957, 1950.
Lauge-Hansen N: Fractures of the ankle. III. Genetic roentgenologic diagnosis of fractures of the ankle. Am J Roentgenol Radium Ther Nucl Med 71 : 456, 1954.
Thomsen NO , Overgaard S & Olsen LH et al.: Observer variation in the radiographic classification of ankle fractures. J Bone Joint Surg Br 73 : 676, 1991.
Pai VS: Medial malleolar fracture associated with deltoid ligament rupture. J Foot Ankle Surg 38 : 420, 1999.
Rasmussen S , Madsen PV & Bennicke K: Observer variation in the Lauge-Hansen classification of ankle fractures. Precision improved by instruction. Acta Orthop Scand 64 : 693, 1993.
Lesic A & Bumbasirevic M: Ankle fractures. Curr Orthop 18 : 232, 2004.
Haraguchi N , Haruyama H & Toga H et al.: Pathoanatomy of posterior malleolar fractures of the ankle. J Bone Joint Surg Am 88 : 1085, 2006.
Michelson JD: Ankle fractures resulting from rotational injuries. J Am Acad Orthop Surg 11 : 403, 2003.
Scheidt KB , Stiehl JB & Skrade DA et al.: Posterior malleolar ankle fractures: an in vitro biomechanical analysis of stability in the loaded and unloaded states. J Orthop Trauma 6 : 96, 1992.
Donken CC , Goorden AJ & Verhofstad MH et al.: The outcome at 20 years of conservatively treated “isolated” posterior malleolar fractures of the ankle: a case series. J Bone Joint Surg Br 93 : 1621, 2011.
Weber M: Trimalleolar fractures with impaction of the posteromedial tibial plafond: implications for talar stability. Foot Ankle Int 25 : 716, 2004.
McConnell T , Creevy W & Tornetta P III: Stress examination of supination external rotation-type fibular fractures. J Bone Joint Surg Am 86 : 2171, 2004.
Kwon JY , Gitajn IL & Walton P et al.: A cadaver study revisiting the original methodology of Lauge-Hansen and a commentary on modern usage. J Bone Joint Surg Am 97 : 604, 2015.
Michelson J , Solocoff D & Waldman B et al.: Ankle fractures. The Lauge-Hansen classification revisited. Clin Orthop Relat Res 345 : 198, 1997.
The Lauge-Hansen classification does not cover all types of ankle injuries. The present report details three cases of exceptional fragment of the medial tibia that differed from the traditional Lauge-Hansen supination–external rotation and pronation–external rotation fracture patterns. The information obtained from this study will be helpful for conducting basic research of this condition and determining appropriate surgical approaches.
Department of Orthopedics, Wuhan Fourth Hospital, Hubei, People's Republic of China.