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
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