Rockwood Adults CH64

2833

CHAPTER 64 • Ankle Fractures

Supinated foot

External rotation

Adduction

I

I

Anterior tib-fib sprain

Talofibular sprain or avulsion of distal fibula

Transverse fibula or rupture of talofibular ligaments

II

II

Stable short oblique fracture of the distal fibula

Vertical medial malleolus with a transverse distal fibula and possible medial plafond impaction

III

Similar to II with additional rupture of posterior tib-fib ligament or fracture of posterior margin

Posterior malleolus or

posterior tib- fib ligament

IV

Unstable short oblique fracture of the distal fibula with a medial malleolus fracture or a deltoid ligament disruption

Figure 64-8.  Schematic diagram and case examples of Lauge-Han- sen SER and SA ankle fractures. A: A supinated foot sustains either an external rotation or adduction force and creates the successive stages of injury shown in the diagram. The SER mechanism has four stages of injury, and the SA mechanism has two stages. ( continues )

Medial malleolus or deltoid

A