Type B, resulting from external rotation, is depicted as a short oblique fibular fracture directed mediolaterally upward from the tib ial plafond. Type A is a transverse fibular fracture caused by adduction and internal rotation. The Danis-Weber classification is based on the premise that the higher the fibular fracture, the greater the syndesmotic injury, likelihood of displacement, and need for open reduction and internal fixation (ORIF). Thus, while the therapeutic practicality of Lauge-Hansen's approach may be called into question, he did advance the understanding of ankle injuries significantly by defining clearly the relationship between ligamentous injury and fracture pattern, and by describing the sequences and degrees of injury produced by forces acting in different directions. However, his elaborate descriptions of "pathogenetic reduction" are cumbersome and probably unnecessary, since it has not been substantiated that reversing the injuring forces in this manner produces a more anatomic or stable reduction than their reversal in random order. ![]() ![]() ![]() Lauge-Hansen believed that closed reduction of ankle injuries should be based on a reversal of the injuring forces in exact inverse order to that in which they occurred. Another shortcoming of the Lauge-Hansen classification lies in its failure to distinguish clearly between nonarticular posterior lip fractures and fractures that involve the articular surface, which entail the addition of axial loading for their production.
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